Nutrients doi: 10.3390/nu18162648

Authors: Amir Y. Kamel Christopher Miquel-Chambers Yasmeen Saker Devika Dixit Melanie Rolfe Zachary D. Johnson Isabela Hernandez Thakul Rattanasuwan Nofel Iftikhar Naueen Chaudhry Angela Pham S. Devi Rampertab Ellen Zimmermann

Background/Objectives: Micronutrient deficiencies are common in inflammatory bowel disease (IBD) and contribute to anemia, impaired wound healing, neurologic injury, and adverse disease outcomes. Major societies, including ESPEN, ACG, and ECCO, recommend nutritional and micronutrient assessment in patients with IBD, yet few studies describe how comprehensively these recommendations are applied during hospitalization. This study aimed to characterize inpatient testing practices for vitamins B1, B6, B12, and zinc in hospitalized IBD patients, quantify deficiency frequency among those tested, and identify gaps between guideline-recommended and actual micronutrient assessment. Methods: A retrospective chart review was performed on adults with Crohn’s disease (CD) or ulcerative colitis (UC) hospitalized for an IBD flare at a tertiary care center. Demographics, comorbidities, and deficiency-associated clinical features were recorded. Yield was defined as the proportion of tested patients meeting institutional deficiency thresholds. Yield for each non-B12 micronutrient was compared with B12 as an internal benchmark. Results: Among 356 patients (285 CD, 71 UC), inpatient micronutrient testing was markedly imbalanced: B12 was tested in 97.2%, whereas B6, B1, and zinc were tested in only 34.8%, 30.6%, and 18.8%, respectively. Among those tested, deficiencies were common: B6 40.3%, zinc 32.8%, B1 22.9%, and B12 9.0%. Each non-B12 micronutrient yielded deficiency significantly more often per test than B12 (all p < 0.001), a testing-yield mismatch interpreted cautiously given selective testing of non-B12 nutrients. Deficiency frequencies did not differ significantly between CD and UC. Clinical contexts included tachycardia and edema (B1); elevated inflammatory markers and thromboembolism history (B6); anemia and neuropathy (B12); and diarrhea and hypoalbuminemia (zinc). Conclusions: Inpatient micronutrient assessment in IBD is heavily skewed toward B12, with B1, B6, and zinc under-tested despite a substantially higher yield of identified deficiency per test. This testing-yield mismatch represents a measurable implementation gap between guideline-recommended comprehensive assessment and actual inpatient practice; whether systematic panel-based assessment improves clinical outcomes warrants prospective evaluation.

Nutrients doi: 10.3390/nu18162647

Authors: Rodica Siminiuc Dinu Țurcanu

Background: Standardized institutional feeding systems determine nutritional adequacy entirely through how the provided diet is formulated, yet how completely that formulation is documented is rarely examined. Military operational rations are the most widely deployed example of such a system. Objectives: We aimed to map the global availability of publicly accessible ration composition data; to assess the compositional adequacy of rations with complete profiles; and to test whether dietary diversity predicts micronutrient adequacy where dietary choice is absent. Methods: A standardized seven-step search was applied across 69 countries grouped into ten geopolitical clusters. All analyses used planned ration composition from official and published sources, not the food actually consumed. Compositional adequacy was quantified as mean per-nutrient coverage of the Dietary Reference Intake, and a separate diversity score was correlated with this aggregate measure. Results: Complete micronutrient profiles were publicly accessible for only 8 of 69 countries (11.6%), with post-conflict states showing the highest data-absence rate (80.0%). Vitamin D was the only nutrient critically low across all eight complete-data rations, ranging from 2.9% to 30.0% of the Dietary Reference Intake—a compositional feature, not a measure of personnel status. The correlation between aggregate adequacy and dietary diversity was negligible (r = −0.042). Pakistan’s high aggregate score (90.29%) coexisted with vitamin D at 2.9%, showing how aggregate scores mask single-nutrient deficiencies. Conclusions: Per-nutrient compositional assessment is essential for evaluating standardized institutional feeding; low public data availability does not imply absent nutritional planning.

Nutrients doi: 10.3390/nu18162646

Authors: Berta Schnettler Andrés Concha-Salgado Ligia Orellana-Calderón Mahia Saracostti Katherine Beroíza Héctor Poblete Leonor Riquelme-Segura Germán Lobos Cristian Adasme-Berríos María Lapo

Background: Research on family support has primarily focused on emotional aspects, paying less attention to instrumental support and its concurrent association with food-related well-being. Aim: To explore direct and indirect actor and partner effects among parents’ instrumental family support, diet quality, and satisfaction with food-related life (SWFoL) in dual-earner families with adolescents. Methods: Online surveys were conducted with 860 dual-earner parent dyads and one adolescent child (mean age 12.7 ± 1.8 years; 49.8% female) in Chile. Family members completed the Adapted Healthy Eating Index and the SWFoL Scale; parents also answered an Instrumental Support subscale. Analyses were conducted using a mediation Actor–Partner Interdependence Model via structural equation modeling. Results: Mothers’ and fathers’ instrumental support was positively associated with their own SWFoL, both directly and indirectly via their diet quality. Parents’ support was also positively related to adolescents’ SWFoL directly and indirectly via adolescents’ diet quality. Symmetrical crossover effects between instrumental support and SWFoL emerged for both parents. Mothers’ support was additionally associated with fathers’ SWFoL indirectly through fathers’ diet quality. Conclusions: Instrumental support operates as a vital systemic resource within dual-earner households. By enhancing diet quality, tangible support protects family food-related well-being and embeds adolescents’ nutritional health within the parental resource ecosystem.

Nutrients doi: 10.3390/nu18162644

Authors: Javier Alonzo Campos-González Dana Fernanda Vasquez-Solorio Samuel Flores-Huerta Jenny Vilchis-Gil César Navarro-Hernandez Carlos Juárez-López Miguel Klünder-Klünder Nancy Lucero Martínez-Rodríguez

Background/Objectives: Omega-3 and omega-9 fatty acid supplementation has shown metabolic and immunomodulatory benefits, but evidence in pediatric insulin resistance is limited, and the persistence of effects after treatment discontinuation remains uncharacterized. This study evaluated the independent and combined effects of omega-3 and omega-9 supplementation on the metabolic and inflammatory profile of children with obesity and insulin resistance, during and after active treatment. Methods: This prespecified secondary analysis of a multicenter, randomized, triple-blind, three-arm parallel trial (NCT05488223) included 97 children (8–17 years) with overweight/obesity and baseline insulin resistance (HOMA-IR > 3.0). Participants received 1.8 g/day of omega-3 (n = 32), omega-9 (n = 34), or combined supplementation (n = 31) for 3 months, followed by a 2-month post-intervention follow-up. Metabolic and inflammatory markers were assessed at baseline (T1), end of treatment (T2), and follow-up (T3). The primary outcome was the change in HOMA-IR from T1 to T2. Results: Active supplementation significantly reduced fasting insulin and HOMA-IR in the Combined (p < 0.001) and Omega-9 (p = 0.010 and p = 0.006) groups; at month 5, only the Combined group maintained significant reductions in both. IL-6 and leptin decreased across all groups during intervention and remained reduced at follow-up. Multivariable regression (n = 96) showed the metabolic response was most strongly associated with baseline metabolic status and concurrent BMI reduction rather than intervention group, which was not an independent predictor of metabolic response, nor consistently of inflammatory outcomes (one exception: a smaller IL-4 increase with omega-9, p = 0.043, unconfirmed in GEE). Conclusions: Within-group reductions in HOMA-IR and fasting insulin persisted after discontinuation only in the Combined group, but without significant between-group differences at any timepoint, consistent with response magnitude reflecting baseline status and adiposity reduction rather than treatment group per se. This positions combined supplementation as a potential metabolic adjuvant—not a standalone therapy—for HOMA-IR-defined insulin resistance in pediatric obesity, assessed here via anthropometric and biochemical rather than imaging-based measures.

Nutrients doi: 10.3390/nu18162645

Authors: Marios Hadjivassiliou Richard A. Grünewald Iain D. Croall Nigel Hoggard Graeme Wild Panagiotis Zis Priya Shanmugarajah David S. Sanders

Background: Gluten ataxia (GA) is the most common neurological manifestation of gluten sensitivity. GA is identified by serological evidence of gluten sensitivity when other defined causes for ataxia have been excluded. Whilst there are several serological markers for gluten sensitivity, antibodies against transglutaminase enzyme 6 (anti-TG6) are of particular interest as it is the autoantigen in GA. Our objective was to assess the value of a commercial anti-TG6 ELISA assay in routine clinical practice for the investigation and management of patients with progressive ataxia. Methods: Patients with progressive ataxia underwent standardized clinical and detailed investigative workup. Anti-TG6 was measured using a commercial ELISA assay. Patients with ataxia who were seropositive for any gluten sensitivity-related antibody were offered dietary advice for a gluten-free diet. All patients underwent baseline and follow-up MR spectroscopy scans of the cerebellum. Results: 155/161 (96%) patients with GA diagnosed on the basis of circulating antigliadin antibodies (the original definition of gluten ataxia) were also positive for anti-TG6. In total, 329/425 (77%) patients with idiopathic sporadic ataxia, all other causes of ataxia excluded, were positive for anti-TG6 alone. 115/296 (39%) patients with ataxia due to genetic causes were positive for anti-TG6, as were 17/59 (29%) patients with a clinically established cerebellar variant of multi-system atrophy. Amongst patients with other neurological conditions (non-ataxia), anti-TG6 was found in 13%, compared with 50% of patients with coeliac disease presenting to gastroenterologists. Overall, 146 patients with ataxia and anti-TG6 alone responded to a gluten-free diet, with a reduction/elimination of TG6 antibodies and improved MR spectroscopy. Patients with an identified genetic ataxia and anti-TG6 did not show a significant response to a gluten-free diet. Conclusions: Anti-TG6 appears to be a more sensitive diagnostic marker for GA when compared to antigliadin antibodies. Patients with ataxia and isolated anti-TG6 benefit from a strict gluten-free diet.

Nutrients doi: 10.3390/nu18162643

Authors: Vignesh Balasubaramaniam Megan Scobie Mary O’Kane Yitka Graham Andrew G. Robertson Kamal Mahawar

Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual incretin therapies have significantly advanced obesity management by facilitating clinically significant weight loss and enhancing cardiometabolic outcomes. Nevertheless, their growing application calls for careful consideration of nutritional and behavioural factors, including decreased dietary intake, gastrointestinal symptoms, loss of lean mass, micronutrient deficiencies, and potential weight regain following treatment cessation. Methods: This narrative review synthesises evidence from clinical trials, observational studies, reviews, professional guidelines, and MBS nutrition protocols to evaluate the role of structured dietetic care in adults receiving GLP-1 RAs or related incretin-based therapies for weight management. MBS pathways provide a comparative framework for investigating how established principles of nutritional assessment, monitoring, and dietetic follow-up may inform pharmacological treatments of obesity. Results: The literature indicates that pharmacological weight-loss treatments should not be administered solely as prescription-based treatments. Structured dietetic care can facilitate nutritional assessment, personalised dietary interventions, the management of gastrointestinal symptoms, protein optimisation, behavioural counselling, physical activity support, and long-term weight maintenance. MBS pathways illustrate the role of dietitians in pre-, peri-, and post-major weight-loss interventions through assessment, guidance on supplementation, dietary progression, biochemical monitoring, and long-term maintenance. Although these principles require adaptation rather than direct application to GLP-1 RA pathways, they offer a valuable system for integrating dietitians into comprehensive obesity pharmacotherapy. Conclusions: Structured dietetic care should be regarded as a fundamental component of the pharmacological management of obesity, especially as GLP-1 RAs and incretin-based therapies become more prevalent. Dietitians are well positioned to help optimise nutritional adequacy, preserve lean mass, manage gastrointestinal symptoms, and support sustained weight maintenance. Future research should investigate effective models for delivering dietetic care alongside incretin-based therapies, including strategies to identify patients who need more intensive support.

Nutrients doi: 10.3390/nu18162642

Authors: Maciej Wilski Jarosław Gabryelski Waldemar Brola

Background/Objectives: Emotional overeating may be relevant to nutritional self-management in people with multiple sclerosis (MS), but its links with disease-related appraisals and psychological adjustment remain unclear. This study examined associations between perceived physical impact of MS and emotional overeating, considering illness acceptance and psychological distress. Methods: This secondary cross-sectional study included 382 adults with MS recruited from specialist clinical centres in Poland. Emotional overeating, perceived physical impact, illness acceptance, and psychological distress were assessed using the My Eating Habits Questionnaire, Multiple Sclerosis Impact Scale-29 physical subscale, Acceptance of Illness Scale, and 12-item General Health Questionnaire. Hierarchical regression and serial indirect-association models were adjusted for disease duration and Expanded Disability Status Scale score. Indirect associations were evaluated using 5000 bootstrap resamples. Results: Greater perceived physical impact was associated with emotional overeating at the bivariate level. In the adjusted regression model, greater psychological distress was associated with higher emotional overeating (B = 0.169, β = 0.312, p < 0.001); the model explained 20.1% of outcome variance. The total association between physical impact and emotional overeating was statistically significant (B = 0.038, p < 0.001), whereas the direct association was not (B = 0.010, p = 0.216). Indirect associations were supported through psychological distress alone (estimate = 0.016, 95% CI 0.009–0.025) and sequentially through lower illness acceptance and greater psychological distress (estimate = 0.006, 95% CI 0.003–0.009). Conclusions: Emotional overeating was more closely associated with psychological distress and illness adjustment than with perceived physical disease impact alone. Nutritional care may benefit from attention to emotional triggers for eating and psychological distress; longitudinal studies are needed to establish temporal relationships.

Nutrients doi: 10.3390/nu18162641

Authors: Kailang Mu Meihui He Ruiqi Liao Changliu Shao Pingxuan Xie Junli Xie Yuchen Liu Zhigang Ju Ke Zhong Yuan Yuan Yuxin Pang

Immunosenescence is a major contributor to age-associated morbidity, yet microbiota-directed strategies capable of restoring immune homeostasis remain insufficiently validated. Medicinal plant polysaccharides (MPPs) are structurally diverse macromolecules that often resist host digestion and undergo microbial transformation in the colon, but their effects cannot be interpreted as those of a homogeneous intervention class. In this structured narrative review, we critically synthesize evidence across structural carbohydrate biology, microbial ecology, metabolite signaling, and immune aging and propose a structure–microbiota–metabolite–immunity framework for evaluating how MPPs may influence immunosenescence. Monosaccharide composition, glycosidic linkages, molecular-weight distribution, branching, uronic acid content, chemical substitutions, and higher-order conformation can shape microbial carbohydrate-active enzyme activity, polysaccharide utilization, and ecological cross-feeding. The resulting changes in short-chain fatty acids, secondary bile acids, tryptophan-derived indoles, and other metabolites may affect epithelial barrier integrity, regulatory T-cell/T helper 17-cell (Treg/Th17) balance, macrophage polarization, nuclear factor-κB (NF-κB) signaling, NLR family pyrin domain-containing 3 (NLRP3) inflammasome activation, and systemic inflammatory tone. However, evidence from in vitro systems and young disease models primarily supports mechanistic plausibility and should not be treated as direct evidence of immunosenescence modification. Translation will require structurally defined preparations, causal validation in aging-relevant models, comparison with established fermentable fibers, identification of responder phenotypes, and adequately powered trials in older adults.

Nutrients doi: 10.3390/nu18162640

Authors: Shupeng Mai Jinji Xu Zihan Hu Chengdi Shan Yuqi Zhao Hongwei Liu Qi Song Zhenni Zhu

Background/Objectives: Although efficacious in randomized trials, the real-world adoption of AI-driven dietary management applications remains uncertain across diverse dining contexts and populations. Methods: This field-based observational study was conducted over 18 days at three real-world dining sites in Shanghai, China, enrolling 181 participants stratified into three groups based on food service style and customer attribute. A cross-sectional survey was administered on day 9, followed by a 9-day prospective usage tracking period. Results: After adjusting for sex, Group 2 (staff cafeteria with fixed-portion dishes) had the highest adjusted mean usability score at 71.20 (p < 0.001). Group 3 (community canteen) had the highest mean scores for information quality (16.57, p = 0.03) and perceptions of intended use in nutrition (12.01, p = 0.08). However, Group 3 recorded zero active usage sessions despite favorable initial perceptions. Conclusions: Favorable user perceptions of this AI-driven dietary management tool did not automatically translate into adoption. Scenario-specific usability and digital divide constraints define the boundary of real-world efficacy; moreover, AI may amplify existing dietary self-management behaviors rather than creating them de novo.

Nutrients doi: 10.3390/nu18162639

Authors: Senthilkumar Sankararaman Terri Schindler Kay Vavrina Maria Mascarenhas

Vitamin A plays an important role in multiple homeostatic functions such as vision, immunity, epithelial cell integrity and differentiation, cell signaling, pulmonary function, reproduction, growth, and development. Vitamin A deficiency was described in people with cystic fibrosis (pwCF) due to a multitude of causes, such as suboptimally managed exocrine pancreatic insufficiency, advanced cystic fibrosis-related liver disease (aCFLD), and a history of intestinal resection, and is generally rare in contemporary practice. Apart from true vitamin A deficiency, low vitamin A levels may also be noted in various inflammatory states, as vitamin A is a negative acute-phase reactant. In the current era of cystic fibrosis (CF) transmembrane-conductance regulator (CFTR)-directed therapies, there is a paradigm shift in vitamin A status, with deficiency statuses becoming rarer, and instead higher serum vitamin levels (in some cases, even in the hypervitaminosis range) are increasingly reported. People with aCFLD, renal insufficiency, post-lung transplantation, and pregnancy are prone to vitamin A toxicity. Hence, CF clinicians should be proactive in evaluating these abnormalities and proficient in managing both deficiency and toxicity, as both these conditions can be associated with adverse outcomes. In this review, we detailed the basics of vitamin A metabolism, manifestations of both vitamin A deficiency and excess, and their clinical implications in pwCF.

Nutrients doi: 10.3390/nu18162638

Authors: Kasuen Mauldin Anthony D. Pham Sneha Dodaballapur Berkeley N. Limketkai

Artificial intelligence (AI) is increasingly being applied in healthcare, with growing relevance to clinical nutrition. This narrative review examines current and emerging uses of AI in nutrition care within the Nutrition Care Process framework, with attention to assessment, monitoring and evaluation, diagnosis, intervention, and clinical support tools. Current applications include AI-assisted dietary assessment using image recognition, wearable sensors, analysis of continuous glucose and other physiologic data for early risk detection, and support for malnutrition screening and diagnosis. AI is also being explored for identifying micronutrient deficiencies and complications of nutrient excess, as well as for screening and early intervention in eating disorders. In nutrition intervention, AI has potential to support personalized dietary planning, nutrition support in intensive care settings, behavioral interventions, and precision nutrition approaches such as digital twins. Additional applications include clinical decision support and documentation assistance. However, despite its usefulness, concerns about AI systems exist. Its performance depends on the quality of the data used to train it; it can introduce bias, and it can produce inaccurate or misleading outputs. In addition, overreliance on AI may also reduce clinician attentiveness and contribute to cognitive errors. For these reasons, AI should be regarded as a support tool rather than a replacement for human clinical care. Overall, AI offers substantial opportunities to improve the personalization, efficiency, and scalability of clinical nutrition practice, but its safe and effective implementation will require continued validation, careful oversight, and integration with clinical expertise.

Nutrients doi: 10.3390/nu18162637

Authors: Maria P. Koliou Chrysoula Karaiskou Charalampos Eleftheriadis Dimitris Skalkos

Background: Eating-rate regulation is a multidimensional behavioral process shaped by oral-processing dynamics, interoceptive cues, sensory engagement, and contextual influences. Despite its relevance, no validated self-report instrument currently assesses these mechanisms. Methods: The Food Consumption Rate Questionnaire (FCRQ) was developed as a behaviorally informed tool for measuring eating-rate regulation. Item generation followed a theory-driven process supported by expert review, forward–backward translation, and pilot testing. Structural validity was examined through Exploratory Factor Analysis (Principal Axis Factoring, Promax rotation) and a theory-driven Confirmatory Factor Analysis evaluating the proposed four-domain model. Reliability was assessed using Cronbach’s α and corrected item–total correlations. Behavioral heterogeneity was explored using hierarchical and k-means cluster analysis. Results: A clear four-factor structure emerged—Slowness, Awareness of Eating Rate, External Factors, and Awareness & Enjoyment—explaining 42.77% of the variance. CFA indicated acceptable model fit (CFI = 0.93, TLI = 0.91, RMSEA = 0.052), supporting the adequacy of the theoretical structure. Reliability indices were consistent with the multidimensional nature of the construct. All four domains were positively correlated. Cluster analysis identified distinct behavioral profiles, illustrating the instrument’s discriminative capacity. Conclusions: The FCRQ provides the first behaviorally informed, psychometrically evaluated framework for assessing eating-rate regulation. The instrument demonstrates a coherent theoretical structure, satisfactory early-stage validity, and the ability to differentiate meaningful behavioral patterns. Continued refinement and validation across diverse populations will further establish the FCRQ as a robust measure for behavioral-nutrition research and practice.

Nutrients doi: 10.3390/nu18162635

Authors: Tomasz Olszowski Dariusz Chlubek

The lectin pathway (LP) of complement activation functions as a crucial effector of innate immunity and a homeostatic sensor operating at the intersection of systemic metabolism, nutritional status, and endothelial integrity. This review provides a comprehensive synthesis of current molecular, clinical, and epidemiological literature regarding the environmental and metabolic regulation of this pathway. First, we summarize the biophysical, structural, and stoichiometric requirements for divalent cations in fluid-phase activation and macromolecular assembly, integrating the contrasting roles of calcium (Ca2+) and zinc (Zn2+) into an explanatory Dual-Cation Dichotomy Framework. Second, we evaluate the transcriptomic mechanisms of nutrigenetic licensing, reviewing how fat-soluble vitamins sustain endoplasmic reticulum chaperone networks and mucosal barrier competence. We discuss how these micronutrient-driven axes interact with host genetic diversity, presenting a Nutrigenetic Rescue Framework to contextualize the environmental modulation of low-expressing MBL2 alleles. Third, the LP responds to metabolic and endocrine shifts, focusing on its biomarker value in gestational diabetes and its clinical patterns in type 1 diabetes. These connections to metabolic disease and related microvascular complications are further integrated into a broader Somatotropic-Gestational Sentinel Hypothesis. Fourth, we connect these metabolic profiles with public health challenges, reviewing LP hyperactivation in viral infections and discussing localized surface plasmon resonance (LSPR) biosensors, at present a conceptual, preclinical technology, as a candidate approach for future point-of-care population screening. In conclusion, bridging nutritional biochemistry with metabolic endocrinology and diagnostic technologies that remain largely preclinical outlines a potential shift from empiric management toward biomarker-driven, point-of-care stratification, which could help mitigate both infectious thromboinflammation and chronic microvascular failure once these technologies undergo further mechanistic and clinical validation.

Nutrients doi: 10.3390/nu18162636

Authors: Honglv Xu Dongyue Hu Xiaoxiao Li Jiaxing Yang Danyun Rui Na Liu Huijuan Wu Jieru Yang Litao Chang Feng Jiao

Background/Objectives: Studies suggest a potential link between dietary behaviors, inflammation, and depressive symptoms in adolescents, but longitudinal evidence remains scarce. This study examines the longitudinal associations among unhealthy diets, inflammatory markers, and depressive symptoms in Chinese adolescents. Methods: This prospective longitudinal study enrolled 1693 middle school students (52.3% female) from Yunnan Province, China. Participants were assessed at five waves: October 2022 (T1), June 2023 (T2), October 2023 (T3), June 2024 (T4), and October 2024 (T5). Unhealthy dietary behaviors were assessed using a Food Frequency Questionnaire, and depressive symptoms were measured with the Children’s Depression Inventory. Blood samples were collected to measure inflammatory markers. Generalized estimating equations, generalized linear models, and path analysis were applied to examine the associations and mediating pathways. Results: Prevalence of depressive symptoms increased from 26.3% to 37.3% over 2 years. Compared with Q1 (the lowest quartile), Q4 of unhealthy dietary scores was significantly associated with an increased risk of positive depression symptoms (adjusted OR = 1.20). IL-4 (β =−0.26–−0.17) and CRP (β = 0.64–1.07) were associated with depressive symptoms. However, the mediating role of inflammation in the association between unhealthy dietary scores and depressive symptoms was not statistically significant. Conclusions: Chinese adolescents exhibit both a high clustering of unhealthy dietary behaviors and notably elevated levels of inflammation. Our longitudinal study indicates that the clustering of unhealthy diets and inflammation levels are associated with depressive symptoms among Chinese adolescents.

Nutrients doi: 10.3390/nu18162634

Authors: Andrea Sosa-Holwerda Surya Raj Niraula Wilna Oldewage-Theron Naima Moustaid-Moussa Leslie Thompson Oak-Hee Park

Objectives: The objective of this cross-sectional online survey was to determine university students’ knowledge about whole grain (WG), sorghum, and prediabetes risk. Methods: The survey included 45 items to learn about the students’ WG perception, practices, primary nutrition information source, and physical activity level (PAL). Recruitment was carried out using the university’s official email announcement and data was collected through Qualtrics. Two-hundred-and-forty-eight undergraduate and graduate students, aged 18–44 years, completed the questionnaire. Results: Sixty-three percent of the students were at risk of prediabetes based on the CDC Prediabetes Risk Test, a recommended screening tool by the National Diabetes Prevention Program. Compared to females, males were at a significantly higher risk of prediabetes and T2DM. Males had a mean ± sd score of 1.70 ± 0.93 versus females (0.64 ± 0.92), (t(246) = −9.07, p < 0.001). Participants scored low on overall knowledge (sorghum and WG combined) (4.21 ± 2.04), WG knowledge (2.82 ± 1.03) and sorghum knowledge (3.21 ± 1.23). Despite reporting a high PAL, less than half had a very good health status, with 45.2% of them having overweight or obesity. Social media was the main nutrition information source for 60% of participants. Logistic regression showed that students with obesity had almost four times greater odds compared to those with normal weight (OR = 3.97, 95% CI: 1.66–9.45, p = 0.002). Conclusions: These results have important public health implications, providing the rationale for our future research on a theory-based nutrition education intervention emphasizing sorghum consumption and metabolic effects on individuals with overweight and obesity, aiming to combat diet-related diseases.

Nutrients doi: 10.3390/nu18162633

Authors: Zongmin Shu Qingyi Zhou Mao Zhu Lan Yang Yujie Chen Yongyun Zhang Junlong Bi Weizhen Li Ming Li

Background Aflatoxin B1 (AFB1) is a potent hepatotoxic mycotoxin that induces severe oxidative liver damage. Kaempferol (Kae), a natural flavonoid with known antioxidant properties, has unclear protective effects against AFB1-induced hepatotoxicity. This study aimed to evaluate the hepatoprotective role of Kae and elucidate its underlying mechanism using integrated in vivo, in silico, and in vitro approaches. Methods: In vivo (AFB1-challenged mice) and in vitro (hepatocyte) models were employed, combined with network pharmacology, molecular docking, and molecular dynamics simulations. Liver injury indices, oxidative stress markers, antioxidant enzyme activities, and Keap1/Nrf2 pathway expression were assessed. Results: Kae co-treatment reversed AFB1-induced increases in liver index, serum ALT/AST, histological lesions, and reduced antioxidant capacity in mice. Network pharmacology revealed 59 common targets, with NFE2L2 (Nrf2) as a key node. In vitro, Kae pretreatment significantly lowered AFB1-elevated ROS, MDA, ALT, and AST, while restoring GSH and total antioxidant capacity. Kae reversed AFB1-induced Keap1 upregulation and Nrf2 downregulation, and increased mRNA levels of HO-1, NQO1, SOD, GPX1, and CAT. Molecular docking and simulation showed stable Kae–Keap1 binding (−9.6 kcal/mol) with critical hydrogen bonds (VAL-606) and van der Waals contacts. Conclusions: Kae directly binds Keap1, activates Nrf2 signaling, upregulates antioxidant gene expression, and mitigates AFB1-induced oxidative liver injury. These findings support Kae as a promising candidate for preventing AFB1 hepatotoxicity.

Nutrients doi: 10.3390/nu18162632

Authors: Vincenzo De Leo Claudio Citterio Adam B. Smith Neil Fawkes

Background: Lifestyle intervention is recommended as first-line management for individuals with low-to-moderate cardiovascular (CV) risk and elevated low-density lipoprotein cholesterol (LDL-C), although dietary intervention alone often produces only modest lipid reductions. NUT2 is a proprietary multi-component nutraceutical formulated to target complementary pathways involved in lipid metabolism, oxidative stress and cardiometabolic risk. This study evaluated its efficacy and safety as an adjunct to dietary intervention. Methods: In this randomized, double-blind, placebo-controlled, parallel-group study, 90 adults with low-to-moderate CV risk and elevated LDL-C were randomized to receive NUT2 (n = 45) or placebo (n = 45) for 12 weeks, together with standardized dietary advice. The primary endpoint was a change in LDL-C at Week 12. Secondary outcomes included changes in total cholesterol, triglycerides, fasting glucose, fasting insulin, high-sensitivity C-reactive protein (hsCRP), homocysteine, anthropometric parameters, blood pressure and metabolic syndrome prevalence. Results: Baseline characteristics were generally comparable, although baseline lipid values differed between groups and were accounted for using baseline-corrected change scores. At Week 12, LDL-C decreased by 13.2% with NUT2 and increased by 1.6% with placebo; the baseline-corrected between-group difference was −23 mg/dL (95% CI −29 to −16; p < 0.001). Total cholesterol was also significantly reduced (corrected difference −26 mg/dL, 95% CI −36 to −17; p < 0.001). Significant reductions in homocysteine and lower fasting insulin concentrations were observed with NUT2. Metabolic syndrome prevalence was 13.3% with NUT2 versus 37.8% with placebo at Week 12 (p = 0.008), although this exploratory finding was based on small participant numbers. No significant between-group difference was observed for hsCRP. NUT2 was well tolerated, with no serious treatment-related adverse events. Conclusions: In adults with low-to-moderate cardiovascular risk whose LDL-C remained suboptimal despite dietary intervention, NUT2 produced significant and clinically relevant improvements in LDL-C and total cholesterol over 12 weeks. The significant reduction in homocysteine further supports the broader biological activity of the multi-component formulation. Favourable changes in insulin and metabolic syndrome status suggest potential additional metabolic effects, although these findings warrant further investigation in larger studies specifically designed for populations with metabolic dysfunction. NUT2 was safe and well tolerated. (Clinical trial registry: NCT07492264; trial registration number: NCT07492264, registration date: 23 March 2026.)

Nutrients doi: 10.3390/nu18162631

Authors: Yan Xu Yue Zhang Kaile Guan Qi Chen Chenchen Geng Lingfeng Dan Jiaxin Zhao Yansong Zhang Huimin Lu

Objectives: This study clarified sex-specific short- and long-term impacts of maternal excessive palm oil (plant-derived saturated) and lard (animal-derived saturated fat) intake on offspring reproductive health and underlying mechanisms. Methods: Female mice were randomized to control, palm oil, or lard diets during gestation and lactation. Offspring received a control diet post-weaning until adulthood, followed by an optional 16-week HFD rechallenge. Gonadal weight and organ index, sperm quality, ovarian follicle number, serum sex hormones, metabolic phenotypes (serum lipid profiles, glucose and insulin tolerance), oxidative stress, apoptosis, proliferation, and transcriptomic profiles were detected at weaning, early and late adulthood. Results: In males, excessive maternal lard intake significantly induces sperm malformation and reduces seminiferous tubule diameter and spermatogenic epithelium thickness upon HFD rechallenge during adulthood, with no changes in oxidative stress, proliferation, and apoptosis. Transcriptomics identified Slc24a5 upregulation as a potential correlate through metal ion transmembrane transporter activity and cellular calcium ion homeostasis. Under normal adult diets, reduced sperm motility resulting from maternal excess lard may be mediated by apoptosis, whereas that induced by maternal high palm oil likely arises from suppressed proliferation and thinner spermatogenic epithelium. GO analysis revealed palm oil-specific Ugt1a5 upregulation associated with altered steroid hormone metabolism. In females, maternal palm oil intake reduced primordial follicles and increased atresia, with sequencing predicted to involve Nedd4 downregulation; lard intake elevated ovarian oxidative stress and atresia only upon HFD rechallenge, with Lamc3 upregulation predicted as a putative regulatory factor. Conclusions: Maternal excessive intake of saturated fat exerts offspring reproductive damage in a sex-specific and source-dependent manner with distinct mechanisms. This work provides novel insights into fat source-dependent and sex-specific effects of nutritional interventions during pregnancy and lactation.

Nutrients doi: 10.3390/nu18162630

Authors: Ramón Paniagua Marcela Ávila-Díaz Julia Nava Renata Romero-Salas Juan Carlos H Hernández-Rivera Oliva Mejía-Rodríguez Giorgina B Picolli Mexican Nephrology Collaborative Study Group Mexican Nephrology Collaborative Study Group

Background/Objectives: Low-protein diets (LPD) and very-low-protein diets supplemented with Ketoanalogues (sVLPD) delay initiation of dialysis in non-diabetic patients with chronic kidney disease (CKD). sVLPD is not recommended in patients with type 2 diabetes mellitus (T2DM), and information about LPD supplemented with Ketoanalogues (LPD + KA) is scarce or inconclusive. The objective of this study is to provide further evidence on the benefits and safety of LPD supplemented with KA (LPD + KA) compared with LPD alone in reducing CKD progression in patients with T2DM. Methods: T2DM patients in stages 3b-4 of CKD (n = 149) were included in a multicenter, randomized, controlled trial and received LPD + KA or LPD, 1 year follow-up. Evaluations were carried out bimonthly. In both groups, protein intake was 0.6 g/kg/day, and the LPD + KA group received KA at the recommended dose. The primary outcome was a decline in eGFR, calculated with Creatinine and with Cystatin C. Secondary outcomes were dialysis requirement, deterioration in nutritional status, hospitalization, morbidity, and mortality. Results: During follow-up, protein nitrogen appearance was 0.556 ± 0.119 and 0.576 ± 0.134 g/kg/day in LPD + KA and LPD, respectively (p = 0.002). The decrease in eGFRCysC from the baseline was −4.29 ± 0.96 mL/min in LPD + KA and −8.54 ± 2.19 mL/min in LPD (using linear mixed-effects model, p = 0.012). eGFRCr did not show differences. There were no differences in nutrition status, metabolic control, adverse events, hospitalizations, or hospital days. Conclusions: Ketoanalogues slow the decline in eGFRCyC but not eGFRCr in T2DM patients, even without differences in protein intake. LPD + KA may be considered useful and safe; however, due to limitations in sample size and follow-up, as well as observed changes in Cr metabolism, the results warrant confirmation with a more robust design and a longer follow-up period.

Nutrients doi: 10.3390/nu18162629

Authors: Cecilia Oliveri Herbert Ryan Marini Nunziata Morabito Letteria Minutoli Giovanni Squadrito Silvia Migliaccio Agostino Gaudio Antonino Catalano

Background: Osteoporosis and sarcopenia frequently coexist in older adults and jointly contribute to increased risk of falls and fragility fractures. While adherence to the Mediterranean diet (MD) has been broadly associated with favorable health outcomes, its potential role in modulating muscle-related functional status and, indirectly, fracture risk remains incompletely understood. Objective: To investigate the association between adherence to MD and SARC-F-assessed functional status, and to explore their interplay with FRAX-estimated fracture probability in postmenopausal women evaluated for osteoporosis. Methods: Adherence to the MD was assessed using the Medi-Lite questionnaire. Muscle-related functional status was evaluated through the SARC-F questionnaire and objectively measured by handgrip strength. Fracture probability was estimated using the FRAX tool. Correlation and multivariable analyses were performed to evaluate associations among study variables. In addition, an exploratory indirect-effect analysis was conducted to investigate whether functional status might represent a potential intermediate pathway linking MD adherence and FRAX-estimated fracture probability. Results: A total of 96 participants (median age 66 years) were consecutively recruited. Greater adherence to the MD was associated with lower SARC-F scores (r = −0.292; p = 0.005), indicating better muscle-related functional status. SARC-F scores were inversely correlated with handgrip strength (r = −0.264; p = 0.013) and positively correlated with the estimated 10-year probability of major osteoporotic fractures (r = 0.289; p = 0.005) and hip fractures (r = 0.277; p = 0.008). No significant associations were observed between MD adherence and FRAX-estimated fracture probability, bone mineral density, or prevalent fractures. In the exploratory indirect-effect analysis, a significant indirect association between MD adherence and FRAX-estimated fracture probability through SARC-F score was observed, whereas the direct association was not significant. Conclusions: In postmenopausal women referred for osteoporosis evaluation, greater adherence to the MD was associated with better self-reported muscle-related functional status but not directly with FRAX-estimated fracture probability. These findings are consistent with the hypothesis that functional status may represent an intermediate link between dietary habits and estimated fracture risk. However, because dietary adherence, functional status, and fracture risk were assessed simultaneously, no causal or temporal inferences can be drawn. Consequently, the indirect-effect findings should be regarded as exploratory and hypothesis-generating, requiring confirmation in adequately powered longitudinal and mechanistic studies.

Nutrients doi: 10.3390/nu18162628

Authors: Yang Wang Wang Peng Wei Fan Hang Xiao Shiyin Guo Zhonghai Tang Jingping Qin

Background/Objectives: Inflammatory bowel disease (IBD) is a chronic and recurrent gastrointestinal disorder characterized by intestinal inflammation and gut microbiota dysbiosis, but current therapies remain limited by adverse effects and suboptimal long-term efficacy. Methods: Here, using a dextran sulfate sodium (DSS)-induced mouse model of IBD-like colitis, we investigated the protective effects of Yakuchinone B (YB)—a diarylheptanoid derived from Alpinia oxyphylla with reported anti-inflammatory and antioxidant activities—against inflammatory bowel disease (IBD). Results: YB supplementation significantly alleviated colitis symptoms, as evidenced by reduced body weight loss, lower disease activity index scores, attenuated colonic shortening, and ameliorated histopathological damage. YB also decreased the colonic and serum levels of TNF-α, IL-1β, and IL-6. Microbiome profiling showed that YB restored gut microbial diversity and reshaped microbial composition, with increased abundances of Alistipes and Duncaniella and reduced overgrowth of Akkermansia. Untargeted metabolomics revealed that YB modulated colitis-associated pathways, including purine metabolism, alanine, aspartate, and glutamate metabolism, and steroid hormone biosynthesis. Targeted analysis further showed that YB increased acetate, propionate, and butyrate levels. Conclusions: These results collectively suggest that YB ameliorates DSS-induced colitis by attenuating inflammation, associated with modulation of the gut microbiota-host metabolism axis, and promoting short-chain fatty acid production, supporting its potential as a promising functional dietary candidate for IBD management.

Nutrients doi: 10.3390/nu18162627

Authors: Marilyn S. Nehls

Fruit and fruit-derived interventions, when provided to various populations of interest, have the potential to contribute to cardioprotective benefits. Of particular interest, arterial stiffness serves as an important prognostic marker for cardiovascular disease and events, so many intervention studies have focused on the ability of fruit and fruit-derived interventions to improve arterial stiffness, especially in the aorta. Therefore, the aim of the present narrative review was to examine the available evidence on the relationship between fruit-based interventions and arterial stiffness. Five electronic databases were searched using a structured search strategy through December 2025. Among the 68 identified clinical investigations, findings were heterogeneous, although some studies reported improvements in interventions derived from berries, grapes, citrus fruits, and watermelon. Current evidence does not support favorable effects following interventions derived from tart cherry, and many fruits lack sufficient evidence to determine whether improvements in arterial stiffness are possible. Given the wide variety of polyphenols and bioactive compounds available in fruit and fruit-based interventions, there is strong theoretical potential for these interventions to exert beneficial effects on the cardiovascular system. Nevertheless, further research is warranted to understand whether fruit-based interventions can produce demonstrable changes in arterial stiffness among varying populations, and when such changes are observed, to elucidate the mechanisms underlying these effects. Thus, additional randomized controlled trials, especially with sufficient durations and adequate sample sizes to detect structural changes in the vascular system, are needed.

Nutrients doi: 10.3390/nu18162626

Authors: Marjo J. E. Campmans-Kuijpers Gerard Dijkstra

Background/Objectives: Patients with inflammatory bowel disease (IBD) frequently experience food-related symptoms and express a strong need for dietary guidance, yet evidence-based recommendations remain limited. This often leads to self-imposed dietary restrictions, potentially compromising nutritional intake and food-related quality of life (Fr-QoL). The primary aim of this study was to evaluate changes in Fr-QoL, following personalized feedback on an IBD-specific food frequency questionnaire and access to an online nutritional knowledge portal over a 6-month period. Secondary exploratory outcomes included changes in dietary intake and diet quality. Methods: In this nationwide pre–post study, 108 patients with IBD completed baseline and 6-month assessments. Dietary intake was measured using the validated GINQ-FFQ and Fr-QoL using a 29-item questionnaire. Nutrient intake was compared with EFSA reference values. Participants received automated personalized feedback and had access to educational tools and dietitian resources. Changes over time were analyzed using paired statistical tests. Results: A significant improvement in Fr-QoL was observed (mean difference 8.1 points, 95% CI 5.5–10.7; p < 0.001; Cohen’s d = 0.39). Baseline intake was characterized by high fat and low fiber consumption. After 6 months, total energy intake decreased (p < 0.001), along with reductions in protein, fat, carbohydrates, fiber, and several micronutrients, including iron, folate, vitamin B6, vitamin C, potassium, magnesium, and zinc. Diet quality did not improve, and adherence to EFSA guidelines remained suboptimal. The digital tools were positively evaluated. Conclusions: In this single-arm pre–post study, Fr-QoL scores were higher at follow-up than at baseline among participants who completed both assessments, whereas dietary intake and overall diet quality did not improve. The findings support the feasibility and acceptability of the developed digital tools for dietary assessment and nutrition education, although their effectiveness requires further evaluation in controlled studies. Additional strategies, including structured dietitian-led support combined with digital resources, may be required to optimize nutritional outcomes in patients with IBD.

Nutrients doi: 10.3390/nu18162625

Authors: Mateusz Grajek Alicja Kozik Tomasz Jurys Mateusz Rozmiarek

Background: Restrictive dieting is a common behavior among young adults and may be associated with increased vulnerability to disordered eating. University students represent a population potentially exposed to multiple influences affecting eating behaviors, including academic stress, social pressures, and appearance-related standards promoted through digital media. This study aimed to analyze the relationship between restrictive dietary practices, eating behaviors, and indicators of vulnerability to disordered eating among university students in Poland. Materials and Methods: A cross-sectional study was conducted among 420 university students aged 19–34 years. Data were collected using an anonymous online questionnaire consisting of sociodemographic questions, the original Restrictive Diet Motivation Questionnaire (RDMQ), and the validated Three-Factor Eating Questionnaire-13 (TFEQ-13). Motivational factors were categorized into aesthetic, social, health-related, eating control, and self-discipline, and personal beliefs regarding restrictive dieting. Statistical analyses included the Gamma correlation coefficient, chi-square test, and ordinal logistic regression, with statistical significance set at p < 0.05. Results: Restrictive dieting was reported by a substantial proportion of participants, with women reporting this behavior more frequently than men. The most prominent motivations were related to appearance, weight control, social influences, and personal beliefs regarding restrictive diets. Participants who followed restrictive diets demonstrated higher levels of cognitive restraint compared with those who did not engage in restrictive dieting. Strong associations were observed between cognitive restraint and aesthetic motivations, personal beliefs regarding restrictive dieting, social motivations, eating control and self-discipline, and health-related motivations. Multivariable analysis confirmed that aesthetic motivation, personal beliefs, previous restrictive dieting, and female sex were independent predictors of higher cognitive restraint. Conclusions: Restrictive dieting among university students is strongly associated with appearance-related motives, dieting-related beliefs, and increased cognitive restraint. In this study, eating disorder risk was inferred from behavioral indicators, particularly cognitive restraint, rather than from clinical diagnostic criteria. These findings highlight the need for preventive strategies promoting evidence-based nutrition knowledge, healthy eating behaviors, and a positive body image among young adults.

Nutrients doi: 10.3390/nu18162624

Authors: Anna Wondołowska-Grabowska Ewa Szpunar-Krok Michał Węgielewski Monika Kowalska-Góralska Magdalena Senze Maria Czernicka

Background/Objectives: Brassica vegetables are widely promoted as health-promoting foods, but their functional value is still commonly inferred from glucosinolate content alone. However, glucosinolates are biologically inactive precursors whose nutritional relevance depends on their conversion into bioactive hydrolysis products, particularly isothiocyanates (ITCs). This review aims to reconsider Brassica functionality through an ITC-yield-centered perspective rather than a precursor-content-based approach. Methods: This narrative review synthesizes current evidence on the biochemical, technological, gastrointestinal, and analytical determinants of glucosinolate hydrolysis and ITC formation. Particular attention is given to myrosinase activity, specifier proteins, pH, temperature, tissue disruption, food matrix effects, processing conditions, gastrointestinal transformation, inter-individual microbial variability, and the limitations of precursor-based interpretation. Results: The reviewed evidence indicates that similar glucosinolate profiles can result in markedly different levels of bioactive exposure depending on enzymatic activity, processing history, matrix context, and host-related factors. Therefore, precursor abundance alone is an unreliable surrogate for functional efficacy. Functional optimization should not aim at indiscriminate maximization of glucosinolate breakdown, but rather at selective promotion of beneficial ITC-forming pathways while limiting nitriles, epithionitriles, and goitrogenic products such as goitrin. Conversion efficiency emerges as a critical analytical bridge between glucosinolate abundance and food-level ITC formation, while subsequent bioaccessibility and host-related factors determine realized exposure. Conclusions: Brassica functionality could be more meaningfully evaluated through an ITC-yield-centered framework in which precursor abundance and conversion efficiency determine food-level ITC formation, while subsequent bioaccessibility and host-related factors shape realized exposure. This approach provides an integrative basis for breeding, food processing, product development, dietary guidance, and future evaluation of Brassica foods.

Nutrients doi: 10.3390/nu18162623

Authors: Md Towhidul Islam Tarun Hassan Y. Ebrahim Khalid A. El Sayed

Background/Objectives: Colorectal cancer (CRC) is the second most common cancer-causing death in the United States. The Mediterranean diet, rich in extra-virgin olive oil (EVOO), is associated with a lower risk of colorectal cancer (CRC). Earlier studies reported S-(−)-oleocanthal (OC), the major EVOO phenolic, to be effective in CRC progression and recurrence suppression in a subcutaneous xenograft model by targeting the SMYD2–EZH2/c-MET signaling axis and favorably modulating gut microbiota (GM). However, lead validation in an orthotopically xenografted model that mimics the tumor microenvironment is yet to be achieved. The GM contribution to OC anti-CRC activity remains unknown. Methods: We used an orthotopic intra-cecally xenografted nude mouse model to validate OC anti-KRAS-mutant CRC activity and assessed the contribution of OC GM modulation to this activity using an oral antibiotic depletion strategy. Results: Daily oral 10 mg/kg OC impressively suppressed KRASG13D-mutant CRC HCT-116-Luc progression and metastasis more effectively than intraperitoneal administration 3×/week. By contrast, GM depletion with a broad-spectrum antibiotics cocktail (ABC) partially attenuated this activity, suggesting GM contribution to OC anti-CRC activity. Thus, fecal microbiota transplantation (FMT) was conducted using fresh daily oral fecal GM treatments collected from 20 mg/kg OC-dosed nude mouse donors. A week before FMT dosing, orthotopic HCT-116-Luc tumor-bearing recipient mice were subjected to GM depletion using daily oral ABC dosing. Recipient mice treated with FMT from OC-treated donors exhibited dramatic >99% reductions in primary and near-complete suppression of multi-organ metastatic tumor burden versus FMT controls. Conclusions: Collectively, oral OC is validated as an effective anti-KRASG13D-mutant CRC lead. Future clinical trials can validate its anti-CRC potential in a human model.

Nutrients doi: 10.3390/nu18162622

Authors: Andrea Rodrigues Vasconcelos Denise Deo Dias Ana Carolina Remondi Souza Erlon Oliveira de Abreu-Silva Aline Marcadenti José João Name

Krill oil (KO) is a marine-derived nutritional ingredient distinguished by its unique structural composition and increasing relevance in human nutrition, particularly in the context of healthy aging and preservation of intrinsic capacity. Approximately 30–65% of its fatty acids are esterified to phospholipids, a molecular configuration associated with enhanced bioavailability and efficient tissue incorporation of omega-3 polyunsaturated fatty acids, even at relatively low doses. Antarctic krill (Euphausia superba) originates from minimally impacted marine ecosystems, contributing to a favorable safety profile characterized by inherently low levels of environmental contaminants, including heavy metals and persistent organic pollutants. Beyond its structural and safety attributes, KO provides a complex nutrient matrix comprising approximately 25% total n-3 polyunsaturated fatty acids (PUFAs), including ~14% eicosapentaenoic acid (EPA) and ~6.5% docosahexaenoic acid (DHA), together with choline and astaxanthin. This compositional synergy may modulate inflammatory pathways, redox balance, membrane dynamics, and cellular signaling, thereby influencing physiological systems implicated in aging biology. This narrative review critically examines how these distinctive characteristics translate into clinically relevant outcomes supporting the multifunctional applications of KO in human nutrition. The analysis is structured within the framework of intrinsic capacity, encompassing locomotion, vitality, sensory, cognition and psychological dimensions, as a conceptual model for healthy aging. Considerations on bioavailability, tolerability, and sustainability are also discussed in the context of nutritional strategies promoting healthy longevity.

Nutrients doi: 10.3390/nu18162621

Authors: Jia Yin Zhixu Wang Ye Ding

Early-life nutrition and the gut microbiota interact to shape host health programming. During early-life development, spanning the neonatal period of initial gut colonization through infancy to toddlerhood, the gut microbiota undergoes dynamic succession driven by feeding patterns, host genetic background, environmental exposures, and other intrinsic and extrinsic factors, among which early feeding practices play a particularly prominent role. Among these factors, human milk oligosaccharides (HMOs), key bioactive components of human milk, contribute to the shaping of infant gut microbial ecology by selectively supporting HMO-utilizing bacteria, influencing microbial metabolism and cross-feeding, and exhibiting structure- and context-dependent effects on pathogen–host interactions, intestinal barrier function, and immune responses. This narrative review summarizes the succession patterns of the gut microbiota in early life and the core regulatory mechanisms by which HMOs shape infant gut microbial ecology, aiming to provide a conceptual basis for understanding the potential long-term health implications of early nutritional interventions.

Nutrients doi: 10.3390/nu18162620

Authors: Rachel L. Bailey Sun Young Park Pooja Ichplani Sol Lee

Background/Objectives: This study examines the effectiveness of calorie labeling on restaurant menus by investigating how visual attention is allocated between calorie information and food cues. Although calorie labeling policies are widely implemented, prior research suggests limited impact on reducing energy intake. Methods: Using eye-tracking technology, this study explored how menu design factors (specifically visual food cues) influence attention. Results: Results from a within-subject experiment (N = 82) indicated that calorie labels received significantly fewer visual fixations (in terms of frequency and duration) when food images were present. Conversely, calorie labels did not reduce attention to food cues, highlighting an asymmetry in attentional allocations. Interestingly, restricted eaters were associated with more frequent attention to calorie labels but not with longer sustained attention to those labels. Conclusions: Overall, findings suggest that the motivational responses elicited by food cues undermine the effectiveness of calorie labeling by diverting attention away from nutritional information, limiting its utility as a public health intervention.

Nutrients doi: 10.3390/nu18162619

Authors: David Sánchez-Relinque Alejandro García-García M. Eugenia Valenzuela-Mateos Jara Díaz-Jiménez Álvaro Zambrano-Rico María José M. Alférez Eduardo Sánchez-Sánchez

Background/Objectives: This study evaluated whether phase angle (PhA) was associated more strongly with nutritional and functional vulnerability than with postoperative morbidity. Methods: This cohort included 207 adults undergoing colorectal cancer surgery. Primary outcomes were malnutrition defined according to the Global Leadership Initiative on Malnutrition (GLIM) criteria, low handgrip strength and impaired Short Physical Performance Battery (SPPB) scores; postoperative complications, readmissions and length of stay were exploratory outcomes. PhA was measured by 50 kHz bioelectrical impedance vector analysis. Analyses estimated areas under the curve (AUCs) with 95% confidence intervals and Youden cut-offs; models adjusted for age, sex and body mass index. Results: PhA was lower in participants with nutritional vulnerability than in those without it (4.57 ± 0.62° vs. 5.20 ± 0.69°; p < 0.001). Discrimination was excellent for handgrip strength <10th percentile (AUC 0.803) and acceptable for SPPB < 10 (AUC 0.785), SPPB ≤ 6 (AUC 0.761) and GLIM-defined malnutrition (AUC 0.728) but showed no discrimination for any postoperative complication (AUC 0.507). After adjustment, PhA ≤ 4.7° remained associated with GLIM-defined malnutrition, handgrip strength < 10th percentile and SPPB < 10 but not with any postoperative complication. Conclusions: PhA was more strongly associated with nutritional and functional vulnerability than with postoperative morbidity. Thresholds require external validation; PhA may complement, not replace, GLIM, body composition, handgrip strength and SPPB.

Nutrients doi: 10.3390/nu18162618

Authors: Mor Bensimhon Alice H. Lichtenstein Ruth Birk

Background/Objectives: Individual responses to weight-loss diets vary widely due to genetic, metabolic, and lifestyle factors, motivating individualized approaches over “one-size-fits-all” advice. We aimed to evaluate long-term (12-month) weight loss, weight maintenance, and cardiometabolic outcomes of a cohort following a nutrigenetically tailored Mediterranean-style dietary program in a real-world, community setting. Methods: The retrospective data cohort included 426 Israeli adults (mean BMI 32.11 ± 4.58 kg/m2; 66.9% women) who participated in a nutrigenetic weight-loss program. Following nutrigenetic direct-to-consumer screening of 425 genetic variants, the participants received a 3-month personalized adjusted diet with remote dietitian-led follow-up by telephone, after which they transitioned to a 9-month self-monitoring and maintenance period. Blood biochemical parameters were reported from routine Health Maintenance Organization (HMO) laboratory testing. Weight/BMI trajectories (0–3, 3–6, 6–9, 9–12 months) were evaluated using linear mixed-effects models; biomarker changes were analyzed with repeated-measures MANOVA and follow-up univariate ANOVAs. Results: Model-estimated cumulative weight loss at 12 months was 10.12 kg (11.4% of baseline) with a mean BMI reduction of 3.68 kg/m2 (p < 0.001). The steepest decline occurred during months 3–6 (−1.13 kg/month). Triglycerides (−14.06 mg/dL), total cholesterol (−4.68 mg/dL), LDL cholesterol (−2.49 mg/dL), fasting glucose (−5.14 mg/dL), and HbA1c (−0.14%) improved significantly (p < 0.05), while HDL cholesterol levels remained stable (+0.86 mg/dL; p > 0.05) at 12 months. Among participants with elevated baseline biochemical values, levels transitioned to normal range by 12-month follow-up for triglycerides (46.4%), total cholesterol (29.4%), LDL cholesterol (34.5%), glucose (39.6%), and HbA1c (35.5%). Conclusions: In a real-world cohort, inclusion of genetic information to personalize dietary guidance was implemented through a flexible, individually tailored program supported by an initial 3-month phase of remote dietitian-led counseling. This approach was associated with durable, clinically meaningful reductions in weight and cardiometabolic risk markers over 12 months. Randomized trials are warranted to confirm causality and evaluate cost-effectiveness.

Nutrients doi: 10.3390/nu18162616

Authors: Tingwei Wang Chang Liu Jian Ji Shuang Zhang Shengfang Wu Bangen Xia Ruowei Xia Nian Qu Maiqiu Wang Lei Zhang Yongli Ye

Background: Astilbin is a bioactive flavonoid with documented anti-inflammatory properties; however, its sustained interactions with the gut microbiota remain poorly understood. Fecal samples from three healthy donors were pooled and fermented with astilbin in an in vitro human colonic model over 7 days. This exploratory study aimed to characterize the temporal ecological shifts associated with prolonged astilbin exposure. Methods: Time-resolved 16S rRNA gene sequencing, PICRUSt2 functional prediction, BugBase phenotypic inference, and pseudo-targeted metabolomics were integrated to track microbial-metabolic dynamics. Results: Astilbin exposure was associated with a highly coordinated, three-stage microbial succession. Day 3 (D3) emerged as a putative inflection point, where the enrichment of pioneer degraders (Flavonifractor, Bacteroides) was temporally correlated with the appearance of polyphenol cleavage intermediates. This transition featured an early decrease in markers of proteolytic fermentation alongside a transient in vitro lipid-stress response. By D7, the community shifted toward a stable configuration enriched in butyrogenic taxa (Roseburia, Subdoligranulum, Megamonas), with progressive depletion of potentially opportunistic pathogens (Escherichia-Shigella). Multi-omics integration suggested that these structural successions were strongly associated with marked metabolic shifts. Inflammatory lipid markers (e.g., leukotriene B4) showed a characteristic “D3-burst/D7-clearance” pattern, whereas potentially barrier-protective metabolites, particularly 3-indolepropionic acid (3-IPA, log2FC = 2.00) and urolithin B (log2FC = 1.18), accumulated substantially. Conclusions: This exploratory study provides valuable high-resolution insights into astilbin’s potential as a dynamic ecological modulator. It outlines a temporal framework illustrating how the gut microbiota may shift from proteolytic fermentation toward 3-IPA-associated homeostasis. Although limited by a pooled fecal model and the absence of a vehicle control, these hypothesis-generating findings offer a solid foundation for future in vivo studies and mechanistic validations across diverse human cohorts.

Nutrients doi: 10.3390/nu18162617

Authors: Ruheea Taskin Ruhee Shiori Wakasugi-Onogi Sihui Ma Nobuhiro Nakamura Yasuhiro Seki Katsuhiko Suzuki

Background: Endurance exercise is known to induce the excessive production of reactive oxygen metabolites due to enhanced metabolic activity and inflammation, leading to oxidative stress and related injuries. Sulforaphane (SFN), an isothiocyanate, is broadly acknowledged for its potential antioxidant and anti-inflammatory properties, along with other protective functions. Objective: The purpose of this study was to investigate the effects of short-term SFN precursor supplementation on maximal exercise-induced muscle damage, oxidative stress and endurance capacity in healthy adults. Methods: In a double-blind placebo-controlled crossover design, 14 healthy participants (7 males, 7 females; age, 25.07 ± 1.04 years; weight, 65.28 ± 4.13 kg; height, 170.07 ± 3.46 cm; BMI, 22.48 ± 0.91) received SFN glucosinolate capsules (200 µmol/day) or placebo for 2 weeks during the first trial. Following a three-week washout period, the participants crossed over to the alternate treatment. Maximal exercise tests were performed following each supplementation (SFN or placebo) period. Blood samples were collected at baseline (before treatment), pre-exercise, post-exercise and 2 h after each exercise session. Results: SFN supplementation did not alter endurance capacity or blood cell counts; however, it significantly attenuated serum creatine kinase (CK) activity (p = 0.034; SFN, 121.52 ± 16.89; placebo, 291.84 ± 133.07) and the myoglobin (Mb) concentration (p = 0.011; SFN, 15.82 ± 1.95; placebo; 27.31 ± 5.71) following exercise. Analysis of oxidative stress markers showed no significant changes in the absolute values; however, in the d-ROMs (p = 0.038; SFN, 107.42 ± 2.39; placebo; 112.32 ± 2.11) and OXY-adsorbent tests (p = 0.032; SFN, 115.97 ± 4.15; placebo; 107.73 ± 3.88), the percent changes from the baseline showed a significant interaction with the supplement. These findings suggest that short-term SFN supplementation may mitigate exercise-induced muscle damage and oxidative stress, suggesting a modest influence on the circulating biomarkers associated with muscle damage without altering the endurance capacity of healthy people. Conclusion: SFN intake may be a beneficial, non-invasive strategy to modulate acute biochemical responses to exercise via the antioxidant defense system in physically active individuals.

Nutrients doi: 10.3390/nu18162615

Authors: Natividad Cuadrado-Corrales José J. Zamorano-León David Carabantes-Alarcón Diana María Mérida Andrés Bodas-Pinedo Mario Chico-Rodríguez Ana Lopez-de-Andres Rodrigo Jiménez-Garcia Enrique Redondo-González Lucia Fuentes-Arroyo

Background/Objectives: Ultra-processed foods (UPFs) are linked to cardiometabolic disease, but cross-sectional surveys often underestimate or invert these associations due to age structure, diagnosis-related dietary changes, and reporting bias. This study explores the potential influence of these biases and examines cross-sectional associations between dietary proxies and prevalent cardiometabolic conditions using the most recent national data from Spain. Methods: We analyzed the 2023 Spanish Health Survey (n = 21,032). Body Mass Index (BMI) was derived from self-reported weight and height. Hypertension and diabetes were defined as self-reported medical diagnoses. Dietary items were mapped as UPF-rich proxies, processed-meat exposure, protective dietary markers, and beverage comparators. Weighted logistic models were adjusted for sociodemographic and lifestyle factors. Bias-probing analyses included stratification by self-rated health, exclusion of severe chronic comorbidities (n = 4107), and model-based beverage contrasts. Results: Prevalence reached 53.6% for excess weight, 23.9% for prevalent hypertension, and 7.4% for prevalent diabetes. Weekly fast-food consumption was consistently associated with excess weight (OR 1.20, 95% CI 1.07–1.35), obesity (OR 1.28, 95% CI 1.09–1.50), prevalent hypertension (OR 1.18, 95% CI 1.02–1.37), and prevalent diabetes (OR 1.33, 95% CI 1.10–1.61). Excluding participants with severe chronic comorbidities strengthened the fast-food association with prevalent diabetes (OR 1.46, 95% CI 1.17–1.81). Conclusions: Fast food emerged as the most consistent adverse dietary marker co-occurring across all prevalent outcomes, whereas processed meat was specifically associated with prevalent excess weight and obesity rather than prevalent cardiometabolic diagnoses. Stratified and sensitivity analyses provided empirical patterns consistent with age confounding and possible post-diagnosis dietary changes influencing cross-sectional associations, highlighting the need for cautious interpretation in public health surveillance.

Nutrients doi: 10.3390/nu18162614

Authors: Asher M. Harris Tavor Ben-Zeev Lior Binman Chagai Levi Inbal Weissman David D. Church Abby Fulbright Arny A. Ferrando Jay R. Hoffman

Background/Objectives: Overtraining (OT) syndrome occurs when an athlete’s training load exceeds the athlete’s ability to recover, leading to a performance decrement. The use of nutritional interventions to increase resiliency to OT is a topic of interest for maximizing performance adaptations. The purpose of this study was to determine whether an essential amino acid (EAA) supplementation administered intraperitoneally and orally can mitigate performance decrements and inflammatory responses in an animal model of resistance training-induced overtraining. Methods: Thirty-two C57BL/6J mice were randomly assigned to four groups (n = 8 per group). One group served as a control (CTL), while the other three groups performed a 5-week resistance training ladder climb program. One group trained three days per week for the duration of the program (RT), while the training frequency of the other two groups doubled to six days per week to cause the OT stress. One group of animals were provided with EAA (RTOEAA), while the other received a sham (RTO). Changes (∆) in maximal carrying load (MCL) were assessed. Results: RTO experienced a greater decrease in ∆MCL than RT (p = 0.002) and RTOEAA (p = 0.029). No differences (p = 0.254) were noted between RT and RTOEAA. In addition, TNF-α expression within the plantaris muscle was significantly elevated in RTO compared to all other groups. Significant decreases in the androgen receptor were also noted for RTO in the soleus compared to RT and CTL. Conclusions: Results demonstrated that EAA supplementation was able to increase resiliency and reduce the inflammatory response to the volume overload stress.

Nutrients doi: 10.3390/nu18162613

Authors: Danelle A. Johnson Edwin Feghali Osman Mohamed Elfadil Jithinraj Edakkanambeth Varayil Manpreet S. Mundi Ryan T. Hurt

Home enteral nutrition (HEN) is essential for patients with a functioning gastrointestinal tract who cannot meet nutritional needs orally, yet outpatient management remains complex, resource-intensive, and supported by a limited evidence base. Artificial intelligence (AI) may augment HEN care by extending monitoring, education, risk assessment, documentation support, and operational coordination into the home environment. Consistent with the narrative review format, this article uses a pragmatic, transparent synthesis of influential HEN-specific literature, relevant clinical nutrition evidence, and background knowledge from adjacent fields, including home healthcare, chronic disease management, oncology nutrition, telehealth, and software regulation. Direct evidence in established HEN populations remains scarce; therefore, most AI applications should be considered hypotheses or early implementation opportunities rather than proven standards of care. The strongest near-term opportunities are clinician-supervised patient education, symptom triage, adherence support, remote monitoring, and workflow automation. Predictive analytics, smart pumps, and precision enteral prescription tools are promising but require prospective HEN-specific validation, interoperability with electronic health records and home-infusion systems, reimbursement pathways, and governance safeguards. Key barriers include dataset bias, limited external validation, alert fatigue, privacy and regulatory concerns, unclear accountability, digital equity, cost uncertainty, and the risk of dehumanizing care. AI should be viewed as a complement to multidisciplinary HEN expertise. Priorities for the near future include HEN registries, standardized outcomes, prospective validation, pragmatic implementation trials, health-economic evaluation, and transparent oversight that preserves clinician accountability and patient-centered care.

Nutrients doi: 10.3390/nu18162611

Authors: Carmen Vargas Steven Allender Miranda R. Blake Neha Lalchandani Cindy Needham

Objective: To synthesise contemporary Australian evidence on how local governments act to support healthier, sustainable and equitable food environments, and to examine the governance arrangements, policy and planning levers, monitoring practices, and implementation conditions shaping local action. Methods: A rapid review of peer-reviewed and grey literature published between January 2015 and February 2026 was performed. Searches were conducted in Medline Complete, CINAHL Complete, Health Policy Reference Centre and Scopus, alongside structured grey literature searches. Included documents addressed Australian LG food environment roles, policies, planning, governance, or monitoring. Findings were narratively synthesised and mapped to national research priorities. Results: Thirty-eight documents were included (23 peer-reviewed studies and 15 grey literature reports). Evidence clustered most strongly around food systems and food security, governance and multisectoral partnerships, and food environment monitoring, particularly food access profiling, affordability monitoring and mapping activities. In contrast, the extent of coverage on statutory planning mechanisms, formal regulatory powers, and consumer behaviour outcomes was limited. Reports of evaluated interventions were concentrated in bounded organisational settings where councils held clearer jurisdiction, such as sport and recreation facilities. Across contexts, LGs were commonly positioned as convenors, brokers and enablers operating within constrained mandates and fragmented multi-level governance settings. Reported enablers included leadership, dedicated resourcing, partnerships and access to local data; common barriers included limited statutory authority, short-term funding and weak vertical policy integration. Conclusions: Australian local governments are active food system actors, but stronger statutory integration, clearer decision pathways, and more consistent monitoring and evaluation are needed to translate local activity into sustained improvements in healthy, sustainable and equitable food environments.

Nutrients doi: 10.3390/nu18162612

Authors: Makoto Hazama Hiroyo Kagami-Katsuyama Naohito Ito Mari Maeda-Yamamoto Hiromi Kimoto Jun Nishihira

Background/Objectives: The relationship between diet and mental wellbeing is bidirectional: nutritional psychiatry examines effects of diet on mental health, whereas emotional-eating research focuses on the reverse. Although dose–response links between nutrient intake and health outcomes are well studied, few have analyzed such relationships between food-group intake and stress. Using cross-sectional data from a regional observational study of Japanese adolescents and young adults (males: n = 48, age = 32.3 ± 5.23; females: n = 124, age = 29.8 ± 5.77), we estimated dose–response associations between intake frequency of various food groups and stress responses. Methods: Mental and physical health was assessed using the response values for the mental and physical stress-reaction items in the Brief Job Stress Questionnaire. Intake frequency for each food group was obtained from a food frequency questionnaire (FFQ). Although the FFQ provides ordinal frequency categories, we demonstrate that structural equation modeling allows these data to be treated as integer values representing monthly intake frequency, enabling the estimation of associations with stress responses. Results: The analysis showed that, in females, the presence or absence of intake—rather than the frequency of intake—of dark-green and yellow vegetables was associated with the magnitude of stress responses. In contrast, for bread, noodles, and starchy foods, a monotonic positive association was observed between intake frequency and fatigue. Conclusions: Although these associations do not disentangle the bidirectional causal relationship between diet and mental–physical health, they provide evidence on the linear and nonlinear associations between food-group–specific intake frequencies and stress responses in the AYA population.

Nutrients doi: 10.3390/nu18162610

Authors: Yoosun Cho

Background/Objectives: Zero-calorie beverages (ZCB) are increasingly consumed by adolescents, yet their relationship with mental health remains unclear, and whether any association differs by sex has not been established. We examined the association between ZCB consumption and depressive symptoms in a nationally representative sample of Korean adolescents, with sex as a prespecified effect modifier. Methods: This cross-sectional study analyzed 50,972 adolescents aged 12–18 years (50.9% male; mean age, 15.0 years) from the 2025 Korea Youth Risk Behavior Web-based Survey. Self-reported ZCB consumption during the previous 7 days and depressive symptoms during the previous 12 months were assessed. ZCB consumption was categorized as none, ≤2/week, 3–6/week, or ≥1/day. Survey-weighted logistic regression estimated adjusted odds ratios (aORs) with 95% confidence intervals (CIs), with non-consumers as the reference. Effect modification by sex was assessed using interaction terms. Results: Depressive symptoms were reported by 12,954 adolescents (25.4%). ZCB consumption was associated with higher odds of depressive symptoms across consumption categories (aOR for ≥1/day 1.76, 95% CI 1.45–2.13; p for trend < 0.001), after adjustment for sociodemographic and lifestyle covariates. The association appeared stronger among females than among males (aOR 1.14 [95% CI 1.11–1.18] vs. 1.05 [1.02–1.08]; p for interaction < 0.001), though significant in both sexes, and persisted after additional adjustment for co-consumed sugar-sweetened and high-caffeine beverages. Conclusions: In this nationally representative sample, daily ZCB consumption was associated with depressive symptoms, with a stronger association observed among females. Prospective studies are warranted to clarify temporality and underlying mechanisms.

Nutrients doi: 10.3390/nu18162609

Authors: Giulia Bruni Juri Zuvadelli Silvia Maria Bernabei Cristina Bonfanti Barbara Borsani Alice Dianin Annalisa Finizii Aurora Favaro Sara Giorda Giorgia Gugelmo Maria Paola Ierardi Chiara Luciano Marta Muscarella Chiara Pancaldi Sara Parolisi Veronica Perico Valentina Pierattini Cinzia Pistolesi Lidia Pontillo Roberta Pretese Angela Ira Pozzoli Sara Quattrini Alice Re Dionigi Maria Giulia Regazzi Alice Rossi Simona Salera Martina Tosi

Background/Objectives: Hereditary fructose intolerance (HFI) is a rare autosomal recessive metabolic disorder caused by variants in the ALDOB gene, resulting in aldolase B deficiency. Symptoms occur after the ingestion of fructose, sucrose, or sorbitol, leading to metabolic toxicity. Management is exclusively dietary, but clinical practice remains highly variable. This survey aimed to investigate current Italian dietary management practices for patients with HFI. Methods: A cross-sectional centre-level survey was conducted using a 29-item questionnaire distributed to metabolic dietitians within the Italian Society for the Study of Inherited Metabolic Diseases network between April and May 2026. Results: Data from 27 dietitians across 15 Italian inherited metabolic disease centres were analysed. Over half of the centres (53.3%) provided care for both paediatric and adult patients, and all centres (100%) supplied structured educational materials for the fructose-, sucrose-, and sorbitol-restricted diet. Marked heterogeneity was observed in dietary practices, particularly in the classification of sugars and sweeteners, recommendations for cereal-based products, and fibre supplementation strategies. Cereal-based dietary guidance was provided by 10/15 centres (66.7%), ranging from no specific recommendations (5/15, 33.3%) to a preference for refined grains (7/15, 46.7%) or fibre-based restrictions (2/15, 13.3%). With regard to sugars and sweeteners, consensus was observed only for maltitol and sorbitol, which were classified as prohibited by all centres (15/15, 100%). Mannitol and isomalt were prohibited in 14/15 centres (93.3%). All other compounds showed variable recommendations across centres, including xylitol (prohibited 46.7%, permitted 40.0%), erythritol (permitted 60.0%), and sucralose (prohibited 33.3%, permitted 20.0%, restricted 20.0%, unspecified 26.7%). Vitamin C (100%) and folic acid (86.6%) were the most commonly prescribed supplements. One-third (33%) of the centres required the use of fibre supplements or osmotic laxatives to manage chronic constipation, with wide variability in the specific type of fibre recommended. Conclusions: These findings highlight substantial heterogeneity in dietary management of HFI across specialised Italian centres and support the development of evidence-based, standardised nutritional guidelines to improve the consistency of care, nutritional adequacy, and patient outcomes.

Nutrients doi: 10.3390/nu18162608

Authors: Jacky Herzlich Omer Less Bar Frumer Ronella Marom Laurence Mangel Dror Mandel

Background: Donor human milk (DHM) is recommended when the mother’s own milk (MOM) is unavailable for extremely low birth weight (ELBW) infants. However, the impact of DHM implementation on NICUs with already high human milk utilization remains incompletely characterized. Objective: We aimed to evaluate the association between DHM implementation and feeding practices, feeding progression, parenteral nutrition (PN) exposure, and major neonatal morbidities in ELBW infants. Methods: We conducted a retrospective before–after cohort study in a single tertiary NICU including 116 ELBW infants with feeding data through day 28 (58 pre-DHM; 58 post-DHM). Exploratory multivariable models evaluated factors associated with NEC and PN duration. Results: In the post-DHM epoch, enteral feeding was initiated earlier (2 vs. 2.5 days, p < 0.001) and full enteral feeding was achieved sooner (14 vs. 24.5 days, p < 0.001). PN duration was numerically shorter (17.5 vs. 27 days, p = 0.088). Feeding shifted from predominantly exclusive MOM to mixed MOM + DHM regimens, eliminating formula-only feeding. NEC, feeding intolerance, bloodstream infection, and mortality did not differ between epochs. Feeding intolerance was associated with NEC, whereas lower gestational age predicted longer PN duration; epoch was not independently associated with either outcome. Conclusions: In this high-MOM NICU, DHM implementation was associated mainly with earlier feeding progression and reduced formula reliance, without a measurable reduction in NEC.

Nutrients doi: 10.3390/nu18162607

Authors: Maria M. AlAnazi Julie A. Lovegrove Zumin Shi Karani Santhanakrishnan Vimaleswaran

Background/Objectives: Diet is recognized as an important determinant of cardiometabolic health, yet evidence from Middle Eastern populations remains scarce. This cross-sectional study investigated the association between a Prudent dietary pattern and multiple indicators of obesity, type-2 diabetes, and cardiovascular disease in a metabolically healthy Qatari cohort. Methods: Data were obtained from 6919 Qatari adults from the Qatar Biobank study. Participants with diagnosed metabolic disorders, pregnancy, or non-fasting blood samples were excluded. Anthropometric, biochemical, and clinical measurements were collected using standardized protocols. Dietary intake was assessed using a 102-item food frequency questionnaire, and a Prudent dietary pattern was derived through factor loadings analysis. Participants were categorized into low and high intake groups of the Prudent dietary pattern. Associations between the Prudent dietary pattern and cardiometabolic markers were examined using generalized linear models adjusted for age, sex, adiposity, and physical activity with Bonferroni correction applied for multiple testing. Results: After correction for multiple testing, greater adherence to the Prudent dietary pattern was significantly associated with lower fat mass index (β = −0.02, p = 0.0001), fasting insulin (β = −0.05, p = 0.0021), and higher fat-free mass (β = 0.01, p = 5.7 × 10−5). Conclusions: Overall, in a metabolically healthy Qatari population, greater compliance to a Prudent dietary pattern was favorably associated with fat and muscle mass, and insulin regulation after adjusting for age, sex, BMI and physical activity. These findings support the role of dietary habits in greater cardiometabolic health in Middle Eastern Arab populations.

Nutrients doi: 10.3390/nu18162606

Authors: Izabela Łucka Maciej Łucki Patrycja Leśnicka Marta Kopańska

Background/Objectives: Long-term recovery following adolescent anorexia nervosa (AN) remains incompletely understood because restoration of nutritional status does not necessarily coincide with psychological remission. Comprehensive evaluation of recovery requires consideration of psychological, behavioural, and patient-reported outcomes in addition to anthropometric measures. To evaluate long-term recovery following adolescent anorexia nervosa by integrating clinical outcomes, patient- and caregiver-reported experiences, orthorexic tendencies, and eating-disorder psychopathology, and to identify factors associated with persistent psychological impairment. Methods: This retrospective follow-up study employed a cross-sectional survey design. Families of 100 former patients previously hospitalized for adolescent anorexia nervosa in a child and adolescent psychiatric inpatient unit were invited to participate 5–10 years after discharge. Follow-up questionnaires were returned by 23 former patients and 17 caregivers. Former patients completed the SCOFF questionnaire and questions assessing orthorexic tendencies, whereas caregivers and the patients as well provided information regarding their child’s long-term recovery, treatment experiences, current functioning, and selected demographic characteristics. Responses from former patients and caregivers were analysed according to respondent group and the variables available for each group, while information from both groups was used to obtain a comprehensive assessment of long-term recovery. Descriptive and inferential statistical analyses were performed. Results: Mean BMI increased from 13.4 kg/m2 during the acute phase of illness to 18.8 kg/m2 at follow-up, indicating substantial nutritional improvement. Nevertheless, approximately 60% of former patients screened positive on the SCOFF questionnaire, suggesting persistent eating-disorder symptoms despite nutritional rehabilitation. Orthorexic tendencies were strongly associated with positive SCOFF screening results (Cramér’s V = 0.828; p < 0.001). Psychiatric comorbidity and poorer subjective health perception were also associated with less favourable long-term outcomes. Qualitative findings further demonstrated that recovery was perceived as extending beyond symptom reduction to include psychological wellbeing, restoration of autonomy, interpersonal functioning, and social reintegration.

Nutrients doi: 10.3390/nu18162605

Authors: Miaomiao Xu Huiguo Wang Lin Zhu Xiaoguang Liu

Background: Long-term fluctuations in body weight may reflect changes in energy balance, illness, or intentional weight loss. However, their association with subsequent triglyceride concentrations remains uncertain. Objective: To examine the association between long-term weight variability and subsequent triglyceride concentrations while accounting for directional weight change. We also assessed the robustness of the findings to adjustment for adiposity, missing data, and socioeconomic and lifestyle covariates. Methods: We analyzed adults from the China Health and Nutrition Survey who had at least three measured weights during 1989–2006 and a triglyceride measurement in 2009. The core complete-case analysis included 5191 participants and adjusted for baseline age, sex, weight slope, number of weight measurements, and working status in 2009. Weight variability was assessed using the coefficient of variation (CV; per 1 SD increment, standardized among 9500 eligible participants) and average successive variability (ASV; per 5 kg increment). Results: In the core model, each 1 SD increment in CV was associated with 2.7% higher triglyceride concentrations (β = 0.026, 95% CI: 0.007 to 0.045; p = 0.007). Each 5 kg increment in ASV was associated with 10.7% higher triglyceride concentrations (β = 0.102, 95% CI: 0.057 to 0.147; p < 0.001). After further adjustment for baseline BMI in the same BMI-complete sample, the corresponding estimates were 3.6% (95% CI: 1.7% to 5.6%) and 5.6% (95% CI: 1.0% to 10.3%), respectively. Multiple imputation yielded similar estimates. A four-knot restricted cubic spline analysis supported an overall association between CV and triglyceride concentrations (p = 0.016), with no strong evidence of nonlinearity (p = 0.101). Marginal standardization yielded adjusted differences in arithmetic mean triglyceride concentrations of 0.048 mmol/L per 1 SD increment in CV and 0.200 mmol/L per 5 kg increment in ASV. Conclusions: Greater long-term weight variability was associated with modestly higher subsequent triglyceride concentrations. Because of the observational design, the heterogeneous causes of weight change, and the possibility of residual confounding, the findings should not be interpreted as causal or independent of obesity.

Nutrients doi: 10.3390/nu18162604

Authors: Abubakr H. Mossa Walaa Sherif Mohammed Alhalabi Sylia Chehade Razaz Omer Osman Alnakhli Ibrahim Yaseen Hachim Mahmood Y. Hachim

Background: Butyrate is a microbiota-derived short-chain fatty acid with established roles in maintaining intestinal barrier integrity and regulating immune responses. Although its effects have been extensively investigated in immunocompetent models, systemic immune homeostasis in severely immunodeficient hosts remains incompletely understood. This exploratory study evaluated the impact of sodium butyrate (NaB) supplementation on tissue-associated microbial antigen detection and immune marker distribution along different organs in athymic nude mice. Methods: Female NU/J athymic mice were administered either regular drinking water (H2O, n = 10) or NaB-supplemented water (150 mM, n = 5) for six weeks. Intestinal, liver, lung, and kidney tissues were collected for histopathological and immunohistochemical analyses. Expression of microbial antigens, including lipopolysaccharide (LPS) and lipoteichoic acid (LTA), as well as immune-associated markers (CD3, CD8a, CD68, CD278, and transglutaminase-2 [TGM2]), was assessed using a semiquantitative scoring system. Results: NaB supplementation did not significantly affect organ morphology but was associated with better weight gain. Histological examination revealed preserved tissue architecture in all organs, with only mild condensation of small intestinal crypts in NaB-treated mice. Immunohistochemical analysis showed consistently lower LPS expression in NaB-treated animals compared with controls in the small intestine, liver, and kidney, with a borderline reduction in the lungs. Reduced LPS detection was accompanied by significantly lower expression of the macrophage marker CD68 in the kidney. Conclusions: Oral NaB supplementation was associated with lower detection of bacterial antigens in tissues and reduced innate immune expression across multiple organs. These findings support a potential role for butyrate in limiting microbial expression and systemic inflammatory signaling in athymic mice.

Nutrients doi: 10.3390/nu18162603

Authors: Milena Tomanic Srđan Milovanović Olivera Stanojlović Dušan Mladenović Dragana Davidović Milan Dobrić Milena Vesković Katarina Djurdjević Šućro Madžgalj Dimitrije Zdravković Aleksandra Jovanović Maja Lačković

Background/Objectives: Ultra-processed food (UPF) consumption is increasingly recognized as part of broader adverse behavioral and health-related patterns in young people, yet evidence integrating dietary, sleep-related, behavioral, and health characteristics within the same adolescent population remains limited. The relationship between UPF-related dietary patterns and tinnitus is particularly understudied. This study examined factors associated with the highest category of a frequency-based proxy UPF score among adolescents in Belgrade, Serbia. Methods: A school-based cross-sectional study included 1285 students aged 15–19 years from 12 four-year secondary schools selected using a stratified multistage cluster probability sampling design. A frequency-based proxy UPF score was constructed from seven questionnaire-based food categories broadly consistent with UPF-related consumption patterns in the Serbian context. Participants were grouped into three categories using empirical tertile cut-points, and the highest category was modeled as the binary outcome in univariable and multivariable logistic regression analyses. Results: Lower academic achievement (aOR = 2.10; 95% CI: 1.38–3.21), alcohol consumption (aOR = 1.34; 95% CI: 1.04–1.74), and waking tired compared with waking rested (aOR = 1.58; 95% CI: 1.06–2.35) were associated with higher odds of being in the highest proxy-score category after adjustment for the measured covariates. Energy drink consumption frequency was also associated with the outcome after adjustment for the measured covariates (overall p < 0.001). Constant tinnitus showed one of the strongest adjusted associations (aOR = 2.55; 95% CI: 1.77–3.67). Conclusions: Adolescents in the highest category of the frequency-based proxy UPF score exhibited a broader pattern of academic, sleep-related, behavioral, and health characteristics, including a particularly strong association with constant tinnitus. These cross-sectional findings warrant longitudinal research to clarify temporal relationships and underlying determinants.

Nutrients doi: 10.3390/nu18162602

Authors: Anna Celina Owczarczyk-Durma Leszek Czupryniak

Obesity is currently recognized as a global epidemic and contributes to numerous health complications. It is strongly associated with poor dietary habits, including the widespread availability and consumption of high-calorie foods. We conducted a narrative review of publications from major biomedical databases addressing obesity treatment and public-health interventions. One of the strategies for managing obesity is lifestyle modification—balanced diet and regular physical activity—supported by pharmacological and psychological treatment, and, in selected patients, metabolic and bariatric surgery. Beyond patient-level care, public-health-oriented measures should be considered, including taxation of sugar-sweetened beverages, restriction on advertising of unhealthy foods, regulation of the school food environment, front-of-pack nutrition labelling, mandatory food reformulation, subsidies and incentives for healthy foods, urban-planning policies that promote physical activity, and policies that expand access to bariatric surgery. A comprehensive approach integrating clinical care with public-health policy is likely to yield more effective outcomes than either alone.

Nutrients doi: 10.3390/nu18162601

Authors: Riccardo Gurrieri Vladimir Hedrih Ephi Morphew-Lu

Background/Objectives: The integration of nutrition into the psychological sciences and mental healthcare has gained increasing attention with the emergence of Nutritional Psychology as an interdisciplinary field. However, little is known about how professionals approach this interface or the barriers they face. This study aimed to explore the extent to which mental health and nutrition professionals engage with each other’s domains. Methods: This cross-sectional study analyzed survey responses from 196 professionals, including mental health professionals, nutrition professionals, and individuals from related fields recruited through the individual and institutional professional network of the Center for Nutritional Psychology, San Jose, CA, USA. The goal was to examine training, practices, perceived barriers, and interest in collaboration between these professions. Descriptive statistics summarized categorical and quantitative variables. Mann–Whitney U tests with rank-biserial correlation examined ordinal data. Exploratory factor analysis (principal axis factoring, varimax rotation) was applied to barrier ratings. Results: A total of 78.3% of participating mental health professionals reported addressing nutrition in their practice at least occasionally, while a similar percentage (78.5%) of participating nutrition professionals discussed mental health with clients at least occasionally. Despite this engagement, 25% of all participating nutrition professionals and 51% of all participating mental health professionals reported no formal training in the complementary field, with most of their knowledge acquired informally through self-study or workshops. A total of 11 mental health professionals and 13 nutrition professionals did not answer the question about formal education in the complementary field. The highest-rated perceived barriers included a lack of training, unclear professional boundaries, and a lack of a common language, whereas a lack of evidence was perceived as the least critical. Importantly, 99% of respondents who answered the question (n = 84, while 112 participants did not respond), or 42% of all participants, expressed interest in evidence-based interdisciplinary training. A total of 96% of those who answered the question (n = 133, while 63 participants did not answer) or 65% of all participants agreed that collaboration would improve patient outcomes. However, only 49% of all participating nutrition professionals and 50% of all participating mental health professionals reported having collaborative experience. A total of 7 mental health professionals and 16 nutrition professionals did not answer the question about collaborative experiences. Conclusions: Within this self-selected sample, respondents reported frequent cross-disciplinary engagement, limited formal training, and interest in interdisciplinary education and collaboration. These exploratory findings require confirmation in independently recruited and better-characterized samples.

Nutrients doi: 10.3390/nu18162600

Authors: Walter Silva Maria João Campos Angelina Pena

Background/Objectives: The concomitant use of conventional medicines with foods, food supplements, and herbal products has increased, raising concerns about interactions. Despite this, healthcare professionals’ knowledge and clinical practices in this domain remain incompletely characterised. This study aimed to assess knowledge, attitudes, and clinical practices regarding food–drug, herb–drug, and supplement–drug interactions among healthcare professionals (HPs) in Portugal. Methods: A cross-sectional pilot study was conducted among 311 HPs using an online questionnaire; participants were recruited through convenience and snowball sampling. The instrument evaluated perceptions, practices, and knowledge (22 items; score 0–22). Descriptive statistics and non-parametric tests were used for group comparisons. Results: Most participants (90.6%) recognised the clinical relevance of herb–drug interactions; however, only 57.6% reported routinely asking patients about food supplements or herbal product use, and 46.0% about teas or infusions. The median knowledge score was 9.00 (interquartile range 9.00), with a mean of 9.34 ± 5.91. Significant differences were observed between professions (p < 0.001): pharmacists achieved the highest scores and nurses the lowest. In exploratory analyses, academic training and continuing education were associated with higher knowledge, whereas professional experience was not. Conclusions: Among the professionals studied, a discrepancy exists between perceived clinical relevance and actual practice, with important gaps in technical knowledge. Within the limits of this sample, the findings point to a need for improved education and structured clinical approaches to enhance patient safety when medicines and natural products are used concomitantly.

Nutrients doi: 10.3390/nu18162599

Authors: Sung-Gyu Lee Jae-Ho Lee Hyun Kang

Chronic respiratory diseases, including asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis, cystic fibrosis, and chronic bronchitis, are characterized by persistent airway inflammation and mucus hypersecretion, leading to airway remodeling and progressive pulmonary dysfunction. Although current therapies improve disease control, they often fail to adequately target the complex molecular mechanisms underlying chronic airway diseases and may cause adverse effects during long-term use. Natural products have therefore emerged as promising multitarget therapeutic agents because they simultaneously regulate oxidative stress, inflammatory signaling, epithelial dysfunction, and mucus production. Recent evidence demonstrates that marine-derived bioactive compounds and plant-derived phytochemicals modulate key signaling pathways, including nuclear factor-kappa B (NF-κB), mitogen-activated protein kinases (MAPKs), phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt), Janus kinase/signal transducer and activator of transcription (JAK/STAT), the NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome, and nuclear factor erythroid 2-related factor 2 (Nrf2), thereby suppressing airway inflammation, oxidative stress, goblet cell differentiation, and MUC5AC overexpression. Advances in nanoformulation, pulmonary drug delivery, multi-omics, artificial intelligence-assisted drug discovery, and network pharmacology are expected to accelerate clinical translation. Collectively, natural products represent promising candidates for the development of evidence-based functional foods, nutraceuticals, and novel therapeutic strategies for chronic respiratory diseases.

Nutrients doi: 10.3390/nu18162598

Authors: Marco Scaglione Maria Grazia Calevo Sara Pessano Francesca Nastasia Perri Stefano Mariani Paolo Massirio Michela Cassanello Michela Perrone Donnorso Elvira Sondo Mariya Malova Maria Cristina Schiaffino Mohamad Maghnie Luca Antonio Ramenghi

Background: Expanded Newborn Screening (NBS) allows screening for more than 50 inborn errors of metabolism (IEMs), thanks to the use of tandem mass spectrometry (MS/MS). Beyond its primary diagnostic function, NBS offers a valuable opportunity to obtain comprehensive information regarding the nutritional status of each newborn. This aspect is particularly significant in very-low-birth-weight (VLBW) preterm infants, who are at increased risk of multiple perinatal complications. The objective of the present study was to leverage the extensive dataset generated from NBS samples of VLBW infants to explore potential correlations with longitudinal extrauterine growth restriction (EUGR). Methods: We retrospectively analyzed 155 VLBW newborns hospitalized in the neonatal intensive care unit (NICU) and screened at IRCCS Giannina Gaslini Children’s Hospital between May 2021 and December 2023. Forty-six NBS metabolites were evaluated at 48–72 h of life (T0), 30 days of life (T1), and at a body weight of 1800 g (T2). Results: Several metabolites showed significant differences between infants with and without longitudinal EUGR in the univariate analyses across the three sampling time points. However, after adjustment for multiple comparisons using the Benjamini–Hochberg procedure, no metabolite remained significantly associated with longitudinal EUGR. Conclusions: Although several metabolites initially appeared to be promising candidates, no independent metabolic signature of longitudinal EUGR was identified after adjustment for multiple testing. Nevertheless, the biological plausibility of several metabolic pathways potentially implicated in postnatal growth provides a rationale for future prospective studies with larger cohorts and more targeted metabolic panels to better elucidate the biological mechanisms underlying longitudinal EUGR.

Nutrients doi: 10.3390/nu18162597

Authors: Zeina M. Alkhalaf Neil J. Perkins

Background/Objectives: Maternal vitamin D deficiency has been associated with preeclampsia, but evidence regarding preconception partner-specific vitamin D biomarkers is limited. We evaluated associations between preconception maternal and paternal vitamin D biomarkers and the odds of preeclampsia. Methods: This secondary prospective cohort analysis used data from the Folic Acid and Zinc Supplementation Trial (FAZST), a multicenter study conducted in the United States between 2013 and 2017. Of the 2370 enrolled couples who were seeking infertility treatment, 1054 couples achieved a documented pregnancy. Because preeclampsia can only be ascertained among pregnancies progressing beyond 20 weeks of gestation, the primary analytic population was restricted to 826 pregnancies that reached ≥20 weeks, including 98 with preeclampsia and 728 without preeclampsia. Preconception serum total 25-hydroxyvitamin D (25(OH)D), vitamin D-binding globulin (VDBG), albumin, free 25(OH)D, and bioavailable 25(OH)D were assessed in both partners. Multivariable logistic regression models estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Results: In categorical analyses, maternal total 25(OH)D findings were consistent with a possible U-shaped pattern. Compared with concentrations of 30–< 50 ng/mL, concentrations ≤20 ng/mL were associated with higher odds of preeclampsia (aOR = 2.58, 95% CI: 1.13–5.88), as were concentrations ≥50 ng/mL (aOR = 5.45, 95% CI: 1.71–17.41). Similar categorical patterns were observed for maternal free 25(OH)D, with higher odds at concentrations ≤8.25 pg/mL (aOR = 2.23, 95% CI: 1.13–4.43) and ≥12.5 pg/mL (aOR = 4.71, 95% CI: 1.97–11.29), and for maternal bioavailable 25(OH)D concentrations ≤3.5 ng/mL (aOR = 2.61, 95% CI: 1.19–5.72) and ≥5.0 ng/mL (aOR = 5.38, 95% CI: 2.15–13.46). Lower paternal bioavailable 25(OH)D was associated with lower odds of preeclampsia in the fully adjusted model (aOR = 0.50, 95% CI: 0.28–0.89); however, this finding should be considered exploratory. Conclusions: Among pregnancies progressing to ≥20 weeks, lower and higher categories of maternal total, free, and bioavailable 25(OH)D were associated with the odds of preeclampsia relative to intermediate categories. These categorical findings are consistent with a possible U-shaped pattern but do not establish a nonlinear dose–response relationship. Paternal findings were limited and should be considered exploratory.

Nutrients doi: 10.3390/nu18162596

Authors: Niuniu Sun Yongqiang Gao Yu Xing Mingyang Guo Xinyu Xu Jingxi Hu Zitong He Jiapeng Luo Sheng Li Zhaozhao Hui Shunming Zhang

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease worldwide and poses a significant public health challenge. Allicin, a major bioactive organosulfur compound derived from garlic, has emerged as a promising candidate for MASLD prevention and management due to its antioxidant, anti-inflammatory, and metabolic regulatory properties. Despite its potential, evidence regarding allicin’s efficacy on MASLD remains limited and heterogeneous because existing studies have evaluated different garlic-derived interventions across diverse experimental settings. This review therefore distinguishes studies of purified allicin from those of raw garlic, garlic powder, aged garlic extract, black garlic, garlic essential oil, and individual garlic compounds. Preclinical studies using allicin suggest beneficial effects on hepatic steatosis, inflammation, glucose homeostasis, and lipid metabolism. Human studies, however, have evaluated raw garlic consumption or garlic powder supplementation rather than allicin alone. Findings from other garlic preparations and individual compounds are attributed only to the intervention tested, because differences in composition, stability, bioavailability, metabolism, and pharmacological activity preclude their attribution to allicin. Moreover, the available clinical trial evidence comprises five publications derived from only two randomized controlled trials conducted in Iran, both lasting 12–15 weeks. In addition, preclinical evidence most consistently supports regulation of hepatic lipid metabolism, particularly the AMP-activated protein kinase/sterol regulatory element-binding protein-1c-related signaling, as a potential mechanism underlying the anti-steatotic effects of allicin. Additional pathways may involve inflammatory signaling, oxidative stress, gut microbiota, and bile acid-related regulation, although the evidence for several of these mechanisms remains suggestive. Nevertheless, the precise molecular targets and signaling networks underlying these effects remain incompletely understood, and the relevance of allicin to aging-related MASLD is largely unexplored because previous studies have used young animals. Future studies should incorporate aged models and long-term randomized controlled trials across diverse populations to clarify the mechanisms, therapeutic potential, and safety of allicin in MASLD.

Nutrients doi: 10.3390/nu18162595

Authors: Rui Chen Chunnan Yan Xiyu Li Xiaona Pang Junhua Jin Hongxing Zhang Yuanhong Xie

Background: Current understanding of the biotransformation of bioactive compounds in Portulaca oleracea through probiotic fermentation remains limited, and the anti-diarrheal mechanisms of the resulting fermented products have yet to be fully elucidated. Methods: In this exploratory study, we employed untargeted metabolomics together with a senna-induced acute diarrhea mouse model to investigate P. oleracea co-fermented with Lactiplantibacillus plantarum and Bacillus subtilis. Results: Metabolomic profiling identified 220 metabolites significantly altered by fermentation, predominantly comprising increased levels of lipids, phenylpropanoids, and polyketides. Compared with the unfermented P. oleracea control, fermented P. oleracea (FP) effectively reduced the diarrhea index, lowered serum levels of inflammatory cytokines (IL-1β, IL-6, TNF-α) and neurotransmitters (5-HT, substance P), and restored Na+/K+ balance as well as ileal histomorphology. Transcriptomic analysis and RT-qPCR validation further demonstrated that FP modulated the expression of genes involved in focal adhesion, PI3K-Akt, cGMP-PKG, and mineral absorption pathways. Conclusions: Fermented P. oleracea (FP) alleviates acute diarrhea through multi-target mechanisms. Notably, fermentation endows P. oleracea with markedly superior intestinal protective effects relative to the unfermented counterpart. These findings provide preliminary experimental evidence supporting the potential of fermented P. oleracea as a candidate for intestinal protective functional food research.

Nutrients doi: 10.3390/nu18162594

Authors: Noémi Mózes Ágnes Lipécz Tamás Csípő Vince Fazekas-Pongor Dávid Major Wei Yi Hung Virág Zábó Boglárka Csík Ágnes Fehér Bálint Bérczi Lilla Klesch Mónika Fekete

Within the emerging field of nutritional neuroscience, omega-3 fatty acids are among the most extensively investigated dietary bioactive compounds with potential relevance to cognitive aging. As populations continue to age worldwide, identifying modifiable nutritional factors that support cognitive health has become an important public health priority. Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), obtained primarily from marine sources, are integral components of neuronal membranes and serve as precursors of specialized pro-resolving lipid mediators. This narrative review integrates concepts from nutritional neuroscience and geroscience to examine how dietary omega-3 fatty acids may influence biological pathways involved in age-related cognitive decline. Current evidence suggests that DHA and EPA affect multiple processes linked to brain aging, including neuroinflammation, synaptic plasticity, mitochondrial function, oxidative stress, cerebrovascular integrity, cellular senescence, and gut–brain axis signaling. These mechanisms overlap with several hallmarks of aging and may contribute to the maintenance of cognitive function during later life. Observational studies generally associate higher dietary intake or circulating omega-3 status with better cognitive performance and a lower risk of cognitive decline and dementia. Findings from randomized controlled trials are less consistent, although benefits appear more likely in individuals with low baseline omega-3 status, mild cognitive impairment, or increased biological vulnerability. Beyond their established anti-inflammatory effects, omega-3 fatty acids may influence multiple aging-related pathways, particularly inflammaging, vascular aging, and mitochondrial dysfunction. Although heterogeneity in study design, dosage, intervention timing, and participant characteristics precludes firm conclusions, viewing omega-3 fatty acids through a geroscience lens offers a useful framework for interpreting existing evidence and informing future research. Overall, omega-3 fatty acids represent a promising nutritional strategy for supporting cognitive health across the lifespan, warranting further investigation in well-characterized populations and precision nutrition approaches.

Nutrients doi: 10.3390/nu18162593

Authors: Federica Grosso Giuseppe Aprile Sandro Barni Sergio Bracarda Alessandro Bertolini Gianfranco Filippelli Carlo Garufi Silvana Leo Alberto Scanni Maria Giuseppa Sarobba Rosa Rita Silva Luisa Fioretto Paolo Tralongo

Malnutrition, a key factor in oncology, affects 20–70% of cancer patients and influences both cancer risk and outcomes, being linked to decreased treatment tolerance, higher toxicity, lower quality of life, and shorter survival. Although international guidelines recommend early and systematic nutritional screening, its adoption in clinical practice remains inconsistent. This study, promoted by the Italian College of Hospital Medical Oncology Directors (CIPOMO), aimed to provide a national snapshot of current organizational practices regarding nutritional screening, assessment, and management in Italian oncology centers. A 15-item survey was sent to 165 centers to investigate organizational practices and awareness of nutrition and physical activity in cancer care. Data were collected and analyzed as overall percentages. A total of 100 centers responded (61%). Although a nutritional assessment is routinely conducted at diagnosis in 67% of centers (n = 67), only 31 centers perform it for all patients. The remaining centers limit nutritional assessment to high-risk or selected patient groups. Moreover, although 86% of centers have dedicated professionals, multidisciplinary integration remains limited. Validated nutritional screening tools are used in 69% of centers, but follow-up reassessment is rarely systematic (15%). However, awareness of the importance of nutrition is high, with nearly all centers supporting educational interventions and dedicated nutritional pathways. Despite this high level of awareness, a significant gap remains between guideline recommendations and daily clinical practice. Standardizing early nutritional screening, enhancing multidisciplinary collaboration, and ensuring equitable and consistent access to nutritional services are crucial to fully integrating nutrition into oncology care and improving patient outcomes.

Nutrients doi: 10.3390/nu18162592

Authors: Carolina Blagojevic Castro Samantha L. Gardener Farzana Jahan Juliana Chen Belinda M. Brown Ruey L. Loo Kevin Taddei Stephanie R. Rainey-Smith Michael Weinborn Ana Caroline R. dos Reis Manohar L. Garg Ralph N. Martins Hamid R. Sohrabi

Background: Preventive strategies, including adherence to specific dietary patterns, have received increasing attention as approaches to reduce cognitive decline and dementia risk. However, findings remain inconsistent, partly due to differences in dietary assessment methods, cognitive outcomes, and THE consideration of genetic susceptibility factors such as apolipoprotein E (APOE) genotype. Methods: This study examined associations between dietary patterns and longitudinal cognitive change in 185 older adults without dementia from the Western Australia Memory Study. Participants completed a food frequency questionnaire at baseline and underwent comprehensive neuropsychological assessments at baseline and up to five follow-up visits at 18-month intervals. Composite scores were generated for six cognitive domains and the Preclinical Alzheimer’s Cognitive Composite (PACC). Results: Western and Prudent dietary pattern scores were analysed using linear mixed-effects models stratified by APOE ε4 carrier status. Among APOE ε4 carriers, greater adherence to a Western dietary pattern was associated with a faster decline in attention (p = 0.016), whereas no significant associations were observed for the Prudent dietary pattern or among APOE ε4 non-carriers. This association was attenuated after excluding participants with possible baseline cognitive impairment (MoCA < 23). Conclusion: These findings suggest that adherence to a Western dietary pattern may accelerate cognitive decline in individuals genetically at risk for Alzheimer’s disease, highlighting the importance of considering gene–diet interactions when developing dietary strategies for dementia prevention.

Nutrients doi: 10.3390/nu18162591

Authors: Yifan Chen Huizhang Wang Cong Gai Xia Li Yutong Li Yihui Ma Huiming Qi Changhua Shi Yibo Tang

Background: Cordyceps polysaccharides (CSP) have shown neuroprotective potential in models of ischemic stroke, but the underlying mechanisms remain to be clarified. Methods: In this study, the effects of CSP were evaluated in MCAO rats and OGD-exposed BV-2 cells. Results: CSP significantly attenuated ischemic injury and inflammatory responses in both in vivo and in vitro models. Mechanistically, CSP decreased CMPK2 expression, increased TFAM levels, and reduced 8-OHdG expression, suggesting attenuation of oxidative DNA damage and mitochondrial DNA-associated stress. EdU staining further showed that OGD-induced DNA synthesis-related signals were predominantly extranuclear, supporting the possibility of mtDNA-associated alterations under ischemia-like conditions. Moreover, CSP suppressed the upregulation of NLRP3, Caspase-1, N-GSDMD, IL-1β, and IL-18, and reduced LDH release following OGD exposure, suggesting inhibition of inflammasome-associated pyroptotic signaling. Conclusions: These findings suggest that the neuroprotective effects of CSP in ischemic stroke models may be related to the modulation of CMPK2/mtDNA/NLRP3 inflammasome pathway and reduced pyroptosis.

Nutrients doi: 10.3390/nu18162588

Authors: Krzysztof Mizera Dominik Mazurek Alejandro Martínez-Rodríguez Anna Kęska

Background/Objectives: Cognitive fatigue and impaired psychomotor function may contribute to reductions in football-specific performance during prolonged match-like activity. This study evaluated cognitive, psychomotor, sprint, and football-specific locomotor responses to multi-ingredient protocols containing taurine, caffeine, and either 300 or 600 mg·day−1 of phosphatidylserine in professional male football players. Methods: In this randomized, triple-masked, placebo-controlled, parallel-group trial, 97 professional male football players were allocated to placebo (PLA, n = 24), taurine plus caffeine (TC, n = 24), taurine plus caffeine plus phosphatidylserine 300 mg·day−1 (TCP-300, n = 24), or taurine plus caffeine plus phosphatidylserine 600 mg·day−1 (TCP-600, n = 25) for 14 days. Taurine and caffeine doses were 1500 mg·day−1 and 200 mg·day−1, respectively. Outcomes included 30 m sprint performance, visual and auditory reaction time, Stroop-task performance, perceived mental fatigue, GPS-derived locomotor variables, and post-intervention first-to-second-half performance-loss indices during a standardized football-specific exercise protocol. Results: The baseline-adjusted ANCOVA demonstrated a significant treatment-group effect on post-intervention 30 m sprint time. After Holm–Bonferroni correction, significant treatment-related effects remained for Stroop reaction time, visual reaction time, and perceived mental fatigue. No statistically significant treatment-related effect was observed for auditory reaction time (unadjusted p = 0.074; Holm-adjusted p = 0.096). During the post-intervention standardized football-specific protocol, baseline-adjusted GPS-derived locomotor outcomes differed significantly between groups. First-to-second-half performance-loss indices also differed between groups, with the smallest post-intervention losses generally observed in TCP-600. Because comparable decline indices were unavailable at baseline, these findings do not represent intervention-related changes in fatigue resistance. Conclusions: Under the present 14-day experimental conditions, the multi-ingredient protocols containing taurine, caffeine, and phosphatidylserine were associated with more favorable selected cognitive and psychomotor outcomes, 30 m sprint performance, and baseline-adjusted GPS-derived locomotor outcomes than placebo. The groups also differed in post-intervention first-to-second-half performance loss during the standardized football-specific protocol. Because corresponding decline indices were not assessed at baseline, these findings do not demonstrate an intervention-related improvement in fatigue resistance. Numerically more favorable values were observed for several outcomes in TCP-600; however, differences between TCP-300 and TCP-600 were modest and not consistently statistically significant, and the study was not specifically powered to establish a dose–response relationship. Because phosphatidylserine was not tested independently, these findings should be interpreted as responses to the combined multi-ingredient supplementation protocols rather than as effects of phosphatidylserine alone.

Nutrients doi: 10.3390/nu18162589

Authors: Liusheng Mo Fengyu Qiu Yueyao Liu Yuli Zang Cheng Chen

Introduction: Evidence linking Mediterranean dietary patterns and physical activity to mortality and major adverse cardiovascular events (MACEs) after coronary heart disease (CHD) diagnosis remains inconclusive. Methods: The search covered PubMed, MEDLINE, Scopus, Embase, and CENTRAL from January 2015 through 15 June 2026. Comparable hazard ratios (HRs) were pooled using random-effects models; non-equivalent estimands were reported separately. Risk of bias was evaluated with design-appropriate tools and certainty with GRADE. Results: The 40 reports represented 34 data sources and at least 260,354 unique patients, comprising six randomized trials, 30 observational reports, and four comparative nonrandomized studies. In one randomized comparison of Mediterranean and low-fat diets, the HR for MACE was 0.72 (95% CI 0.54 to 0.96; moderate certainty). Observational findings supported inverse associations of closer dietary adherence with all-cause mortality (HR 0.74, 95% CI 0.60 to 0.90; I2 = 44%) and MACE, whereas cardiovascular mortality remained uncertain. HRs for maintained or continued physical activity relative to persistent inactivity were 0.64 for all-cause mortality (95% CI 0.55 to 0.74; I2 = 29%) and 0.42 for cardiovascular mortality (95% CI 0.28 to 0.64; I2 = 72%). MACE findings for diet adherence and habitual physical activity generally favored lower risk. Randomized evidence on exercise or combined dietary and activity programs was sparse. Conclusions: Greater Mediterranean diet adherence and habitual physical activity were associated with more favorable CHD outcomes. Standardized, adequately powered trials are needed, especially for exercise and combined strategies.

Nutrients doi: 10.3390/nu18162590

Authors: Jing Yang Jingmei Dong Hua Yang Chieh-Chen Wu Chun-Hsien Su

How physical activity may modify the health consequences of a pro-inflammatory diet remains an important but unresolved question. This hypothesis-generating narrative review examines this question by integrating evidence on dietary inflammatory potential, physical activity, physiological capacity, and inflammation-related health outcomes, and by proposing an Inflammatory Resilience Framework to guide future research. Current evidence strongly supports systemic inflammation, adiposity, insulin resistance, and vascular dysfunction as relevant pathways linking dietary inflammatory exposure to disease vulnerability, while redox- and gut-related mechanisms remain more indirect. Physical activity and higher physiological capacity may influence several of these pathways through metabolic, vascular, muscular, and inflammatory regulation. Preliminary human joint-association evidence suggests that physical activity may partially attenuate selected consequences of pro-inflammatory dietary exposure, but it does not establish a consistent modifying effect or full compensation. The proposed framework positions physical activity, cardiorespiratory fitness, skeletal muscle function, adiposity, metabolic flexibility, vascular function, and baseline health status as factors that may modify the association between dietary inflammatory exposure and disease vulnerability. Rather than asking whether exercise cancels dietary risk, the framework provides a testable structure for future studies integrating objective physical activity, fitness, physiological reserve, inflammatory and metabolic markers, and longitudinal interaction analyses to determine when, how, and in whom physical activity modifies diet-related inflammatory risk.

Nutrients doi: 10.3390/nu18162587

Authors: Inkyung Baik

Background/Objectives: Few prospective studies have investigated the association between carbonated soft drink (CSD) consumption and psychological distress (PD) among adults. The current study aimed to examine this association according to the BDNF Val66Met polymorphism and to conduct comparable analyses for coffee and green tea consumption. Methods: Cross-sectional data (n = 6244) and 6-year prospective data (n = 1984) comprising participants aged 43–74 years were analyzed. PD was defined as a Psychosocial Wellbeing Index (PWI) score ≥ 27. Beverage consumption was assessed using a food frequency questionnaire. Modified Poisson regression was employed to estimate multivariable prevalence ratios or risk ratios (RRs) and 95% confidence intervals (CIs) for PD. Results: In cross-sectional data, green tea consumption was inversely associated with PD prevalence in the overall study population (p for trend < 0.05), and its dose–response relationship was observed exclusively among BDNF Met allele (CT and TT) carriers. In 6-year prospective data, CSD consumption was positively associated with PD risk among BDNF Met allele carriers only (p for trend < 0.01); multivariable RR (95% CI) for PD among BDNF Met allele carriers was 1.94 (1.21, 3.10)—(95% CI: 1.09, 3.44) after further applying the Bonferroni correction—for those who consumed ≥ 1 cup/week compared with non-consumers. No prospective association was observed for coffee and green tea consumption in the overall study population and genotype-specific analyses. Conclusions: CSD consumption was associated with increased PD risk among individuals carrying the BDNF Met allele, which is known to be associated with various stress-related psychological conditions. These findings suggest that CSD consumption may be particularly harmful to individuals with specific genetic factors.

Nutrients doi: 10.3390/nu18162586

Authors: Loubna Enezari Matteo Della Porta Serena Mazzucchelli Fabio Corsi Jeanette A. Maier Roberta Cazzola

Background/Objectives: Diet is increasingly recognized as a modifiable factor in cancer survivorship; however, the impact of post-diagnostic dietary habits on breast cancer (BC) outcomes remains uncertain. This systematic review aimed to evaluate the association between diet after BC diagnosis and clinical outcomes and to provide an updated synthesis of the evidence, with particular emphasis on dietary assessment methods, methodological heterogeneity, and evidence gaps. Methods: We systematically reviewed randomized controlled trials (RCTs) and prospective cohort studies that investigated post-diagnostic dietary exposures among women with BC. Outcomes of interest included all-cause mortality (ACM), breast cancer-specific mortality (CSM), recurrence (R), overall survival (OS), and disease-free survival (DFS). Sources of methodological heterogeneity were assessed, and findings were synthesized using a structured narrative approach. Results: A total of 39 studies were included (8 RCTs and 31 prospective cohort studies), comprising over 90,000 participants. Evidence from RCTs, including low-fat and multi-component interventions, showed largely null or inconsistent effects on BC-specific outcomes. Findings from cohort studies were heterogeneous. Associations for individual nutrients and food groups were generally inconsistent across studies, whereas healthier dietary patterns and higher diet quality scores were associated with reduced ACM. Associations with BC-specific outcomes were less consistent. Overall, the available evidence was characterized by substantial methodological heterogeneity, overlapping study populations, and low-to-moderate certainty. Conclusions: Current evidence suggests that post-diagnostic dietary habits may contribute more to overall survivorship than to BC-specific prognosis. Methodological heterogeneity, particularly in dietary assessment, should be taken into account when interpreting findings. The principal contribution of this review is the identification of important methodological limitations and evidence gaps that currently limit confidence in the available literature. Future research should employ more accurate dietary assessment methods and comprehensive nutritional evaluation to clarify the role of nutrition in BC outcomes.

Nutrients doi: 10.3390/nu18162585

Authors: Hatice Merve Bayram Arda Ozturkcan

Background: Ultra-processed food (UPF) consumption may be associated not only with nutrition knowledge but also with individuals’ practical food-related competencies and overall dietary patterns. Aim: This study investigated how cooking and food skills, dietary literacy, and adherence to the Mediterranean diet were related to UPF consumption among adults in İstanbul, Türkiye. Methods: This descriptive cross-sectional study included 293 (85.7% female, mean age of 22.63 ± 4.66 years) adults residing in Istanbul, Türkiye between 1 January 2026 and 30 June 2026. Data were collected through an online questionnaire comprising sociodemographic and food-related characteristics, the Cooking Skills and Food Skills Measure, the e-Healthy Diet Literacy Scale (e-HDL), the Mediterranean Diet Adherence Screener (MEDAS), and the Short Screening Questionnaire of Highly Processed Food Consumption (sQ-HPF). Validated Turkish versions of all instruments were used; no measurement tool was developed specifically for this study. Results: 57.0% of participants were classified as having a high level of UPF consumption. The high level of UPF consumption group was younger, cooked at home less frequently, ordered food more frequently, and had lower cooking skills, food skills, and MEDAS scores compared to the low level of UPF consumption group (all p < 0.05). UPF consumption was negatively correlated with food skills (r: −0.33), MEDAS (r = −0.28), cooking skills (r = −0.27), age (r = −0.21), and home-cooking frequency (r = −0.18) and positively correlated with food-ordering frequency (r = 0.18). In the final regression model, younger age (β = −0.144, p = 0.009), lower food skills (β = −0.325, p < 0.001), and lower MEDAS scores (β = −0.252, p < 0.001) were independently associated with higher UPF consumption. E-HDL was not independently associated with UPF consumption. The final model explained 18.4% of the adjusted variance. Conclusions: Among this predominantly young and female sample of adults residing in Istanbul, lower food skills and lower Mediterranean diet adherence co-occurred with higher UPF consumption. Although the direction of these associations cannot be determined, the findings may inform future strategies that integrate nutrition education with practical food preparation support and the promotion of Mediterranean-style food choices.

Nutrients doi: 10.3390/nu18162584

Authors: Haichuan Li Jiazhang Huang Tian Zhang Zhenchuang Tang Qirui Xu Di Gong Liang Wang Ying Zhang

The global prevalence of depression and its profound burden on public health create an urgent need to explore novel interventions beyond conventional therapeutic strategies. Zinc, a key regulator in the central nervous system, exerts multiple biological functions beyond maintaining neurotransmitter homeostasis, including inhibiting neuroinflammation, restoring neuroplasticity, and modulating gut microenvironmental homeostasis. This review summarizes the evidence linking zinc deficiency to the onset and development of depression, with a specific focus on the role of gut microbiota. It also discusses different forms of zinc supplements, highlighting synergistic interventions that combine novel zinc complexes with probiotics. Together, these lines of evidence provide a theoretical basis for innovative adjunctive strategies for depression.

Nutrients doi: 10.3390/nu18162583

Authors: Qonita Rachmah Hai Phung Faruk Ahmed

Background/Objectives: Obesity-related inflammation may disrupt iron homeostasis and increase the risk of iron deficiency, yet evidence among women in low- and middle-income countries remains limited. This study examined the independent association between overweight/obesity and iron status among Indonesian women of reproductive age. Methods: A case–control study was conducted among 340 nonpregnant women aged 20–29 years in Surabaya, Indonesia. Sociodemographic, dietary, menstrual, and anthropometric data were collected alongside venous blood samples. Logistic regression models were used to examine associations between adiposity measures and iron deficiency (ID), anaemia, and iron deficiency anaemia (IDA), adjusting for potential confounders. Results: Inflammation-adjusted serum ferritin was significantly higher among women with overweight/obesity than among normal-weight women (22.39 ± 21.7 vs. 17.78 ± 17.6 µg/L; p = 0.033). Consistent with this, the prevalence of ID was lower among women with overweight/obesity, likely reflecting inflammation-related ferritin elevation that may influence diagnostic classification. BMI-defined overweight/obesity was not independently associated with ID, anaemia, or IDA. In contrast, higher body fat percentage was inversely associated with ID (AOR 0.93; 95% CI 0.86, 0.99) and IDA (AOR 0.86; 95% CI 0.75, 0.99). Elevated alpha-1-acid glycoprotein (AGP) was independently associated with higher odds of IDA, and menstrual iron loss was an independent predictor of anaemia and IDA. Conclusions: BMI alone is insufficient to capture the relationship between adiposity and iron status in women of reproductive age. Body fat percentage appears to be a more sensitive indicator of adiposity-related iron risk. These findings suggest that inflammation associated with adiposity may alter iron biomarkers, and reliance on BMI alone may obscure the true burden of iron deficiency in this population.

Nutrients doi: 10.3390/nu18152582

Authors: Daniela L. C. Delgado-Lara Elizabeth Hernández-Castellanos Diana J. Mejía-Barajas Haru C. B. Angel-González Sofía F. Angulo-Camacho Omar Graciano-Machuca Valeria Diaz-Rizo Liliana Iñiguez-Gutiérrez Teresita J. Hernández-Flores

Background/Objectives: The 2025 Lancet Diabetes & Endocrinology Commission proposed a framework that distinguishes preclinical from clinical obesity based on confirmed excess adiposity and evidence of obesity-related organ dysfunction. We estimated the prevalence and clinical characteristics of preclinical and clinical obesity in Mexican adults and quantified their discordance with conventional body mass index (BMI) categories. Methods: Cross-sectional analysis of 5014 adults aged ≥20 years (weighted population 77,915,402) from the 2023 Mexican National Health and Nutrition Survey (ENSANUT). Excess adiposity was confirmed by a BMI ≥ 30 kg/m2 plus one altered measure of central adiposity, by two altered measures irrespective of BMI, or by a BMI ≥ 40 kg/m2 alone. Obesity-related dysfunction was ascertained from available cardiovascular, metabolic, and functional indicators. All analyses accounted for the complex sampling design. Results: Preclinical obesity affected 30.9% of adults and clinical obesity 19.6%. Among adults with clinical obesity, 4.9% had a normal BMI and 18.3% were overweight so that 23.2% fell below the conventional 30 kg/m2 threshold. Cardiovascular dysfunction was the most frequent qualifying domain (78.1%), followed by limitations in activities of daily living (27.6%) and metabolic dysfunction (6.7%). Conclusions: BMI alone underestimates obesity-related clinical severity and misses a substantial share of adults with organ dysfunction, supporting the integration of central adiposity measures and assessment of obesity-related dysfunction into routine obesity surveillance.

Nutrients doi: 10.3390/nu18152581

Authors: Magdalena Leśniewska Zofia Chyła Zuzanna Dąbrowska Jolanta Sado Kinga Bielarska Szymon Bielecki Zuzanna Pelc Marcin Kubiak Katarzyna Sędłak Radosław Mlak Karol Rawicz-Pruszyński

Background: Composite immunonutritional biomarkers reflecting systemic inflammation, nutritional status, and immune competence have emerged as promising tools for perioperative risk stratification in colorectal cancer (CRC). However, their prognostic value during the perioperative period following minimally invasive CRC surgery remains unresolved. This study aimed to evaluate the association between perioperative inflammatory biomarkers, including the neutrophil-to-lymphocyte ratio (NLR), hemoglobin–albumin–lymphocyte–platelet (HALP) score, and Host Index (H-index), and short-term postoperative outcomes after minimally invasive colorectal cancer surgery. Methods: This retrospective single-center study included 105 patients who underwent minimally invasive curative-intent surgery for CRC between 2023 and 2025. Biomarkers were assessed preoperatively and during the first four postoperative days. Severe postoperative morbidity was defined as a Comprehensive Complication Index (CCI) ≥ 20.9. Results: Among all parameters, NLR measured on postoperative day 3 demonstrated the highest apparent discriminatory ability for severe complications (AUC = 0.87, 95% CI: 0.74–0.95; sensitivity 91.7%; specificity 73.7%). Preoperative HALP was the most informative preoperative marker (AUC = 0.78, 95% CI: 0.66–0.87; sensitivity 76.5%; specificity 87.7%). Conclusions: Perioperative inflammatory and immunonutritional biomarkers are associated with postoperative morbidity following CRC surgery. Preoperative HALP and postoperative day 3 NLR demonstrated the strongest apparent discrimination for CCI ≥ 20.9; however, these findings require confirmation in larger, independent prospective cohorts.

Nutrients doi: 10.3390/nu18152580

Authors: Xiaomeng Tan Wanyan Zhang Yingri Zhang Lv Shang Fang Ye Jian Hou Li Liu Zijian Zhao Zhenyu He

Background: Long-term exposure to fine particulate matter (PM2.5) and its components, as well as lower nutritional scores or irregular leisure-time physical activity, has been individually linked to reduced kidney function. However, the joint associations of PM2.5 component mixture combined with nutritional scores or leisure-time physical activity with estimated glomerular filtration rate (eGFR) remain underexplored, especially among subway workers. Method: This study included 8477 subway workers in Wuhan, China. PM2.5, and component data were obtained from the Tracking Air Pollution in China (TAP) dataset. Leisure-time physical activity was assessed using a self-administered questionnaire adapted from the International Physical Activity Questionnaire (IPAQ). Kidney function was evaluated by creatinine-based eGFR. Nutritional indices of Geriatric Nutritional Risk Index (GNRI) and the Prognostic Nutritional Index (PNI) were calculated. Generalized linear models were used to examine the associations of PM2.5 and each of its components or nutritional indices with lower creatinine-based eGFR. The associations of PM2.5 component mixture with creatinine-based eGFR were evaluated using WQS, QGC, and BKMR models. Joint associations of PM2.5 component mixture with nutritional indices or leisure-time physical activity were further explored. Results: Negative associations of individual PM2.5 components and their mixture with eGFR values were observed. WQS and QGC models showed that the mixture of PM2.5 components was associated with an increased risk of lower creatinine-based eGFR, and their corresponding ORs (95%CI) were 1.183 (1.106, 1.266) and 1.183 (1.083, 1.291), respectively. BKMR analysis further showed the overall effect on eGFR values in relation to a 5-percentile increase in the PM2.5 component mixture was −0.045 (−0.068, −0.022), compared with their levels fixed at their respective medians. Meanwhile, the probability of lower creatinine-based eGFR increased with rising quantiles of PM2.5 component mixture concentration. Notably, differential associations were observed across subgroups classified by nutritional indices or leisure-time physical activity, but no significant interaction was observed. Conclusions: Long-term exposure to residential ambient PM2.5 components or their mixture is associated with lower creatinine-based eGFR. This different association was observed among subgroups classified by nutritional indices or leisure-time physical activity, which may inform hypothesis generation for future studies.

Nutrients doi: 10.3390/nu18152579

Authors: Mei Chou Lai Yu-Shun Tzeng I-Min Liu

Background/Objectives: Alzheimer’s disease (AD) is associated with amyloid-β (Aβ)-induced neuronal injury, oxidative stress, inflammatory activation, and cellular senescence. Phycocyanobilin (PCB), an algae nutritive compound, has shown neuroprotective potential, but whether it attenuates Aβ-induced neuronal senescence remains unclear. This study investigated the protective effects of PCB against Aβ1–42 oligomer-induced senescence-like alterations in SH-SY5Y cells and examined the involvement of sirtuin 1 (SIRT1) signaling. Methods: Differentiated SH-SY5Y cells were pretreated with PCB (50 μmol/L) in the presence or absence of EX527 (10 μmol/L) for 24 h, followed by exposure to Aβ1–42 oligomers (20 μmol/L) for an additional 24 h. Cell viability, lactate dehydrogenase (LDH) release, senescence-associated β-galactosidase (SA-β-gal) staining, senescence-associated heterochromatin foci (SAHF)-associated di-/tri-methylated histone H3 lysine 9 (H3K9me2/3) fluorescence, senescence-associated secretory phenotype (SASP)-related cytokines, phosphorylated histone H2AX (γ-H2AX) accumulation, Ki67 expression, p53/p21/p16 signaling, and silent information regulator 1 (SIRT1) expression and activity were assessed using cell counting kit-8 assay, LDH assay, enzyme-linked immunosorbent assay, immunofluorescence staining, quantitative real-time PCR analysis, Western blotting, and fluorometric enzymatic activity assay. Results: Aβ1–42 oligomers reduced cell viability, increased LDH release, promoted SA-β-gal positivity, enhanced H3K9me2/3 and γ-H2AX signals, elevated IL-1β, IL-6, and IL-8 levels, suppressed Ki67 expression, and upregulated p53, p21, and p16. PCB pretreatment markedly attenuated these cytotoxic, senescence-associated inflammatory, and DNA damage-related responses while restoring SIRT1 mRNA, protein expression, and enzymatic activity. EX527 partially reversed these protective effects. Conclusions: PCB attenuates Aβ1–42 oligomer-induced neuronal senescence-like alterations, at least partly through SIRT1-associated regulation, supporting its potential as a naturally derived anti-senescent neuroprotective compound for AD-related neuronal aging.

Nutrients doi: 10.3390/nu18152578

Authors: Jitendra D. Belani

Background: Type 2 diabetes is characterized by substantial interindividual variability in postprandial glucose responses, yet continuous glucose monitoring (CGM)-derived glucose patterns are commonly described using quantitative metrics without sufficient consideration of the physiological mechanisms that generate them. Objective: To develop a physiology-based framework for interpreting CGM-derived glycemic phenotypes in relation to dietary exposures and individual metabolic characteristics, thereby supporting precision nutrition in adults with type 2 diabetes. Methods: A structured narrative review of the literature was conducted using PubMed to identify studies examining CGM, postprandial glucose regulation, dietary exposures, metabolic physiology, and precision nutrition. Evidence was synthesized within a predefined conceptual framework linking dietary exposures, underlying physiology, individual metabolic characteristics, CGM-derived glycemic phenotypes, and their clinical interpretation. Results: Postprandial glucose responses reflect coordinated interactions among nutrient digestion and absorption, hormonal regulation, hepatic glucose production, peripheral glucose disposal, and individual metabolic characteristics rather than dietary carbohydrate exposure alone. The proposed framework interprets recurring CGM-derived glucose patterns as physiologically meaningful glycemic phenotypes, including characteristic patterns of postprandial excursion, recovery, baseline glycemia, and glycemic variability. This framework provides a structured approach for physiology-informed interpretation of CGM observations and individualized nutritional assessment. Although direct evidence supporting phenotype-guided nutritional interventions and long-term clinical benefit remains limited, emerging computational approaches may further strengthen this interpretive process by integrating CGM with complementary biological and behavioral data. Conclusions: Rather than viewing CGM solely as a technology for measuring glucose, the proposed framework positions it as a physiological lens through which dietary exposures, metabolic regulation, and individual metabolic characteristics can be integrated to support precision nutrition in type 2 diabetes.

Nutrients doi: 10.3390/nu18152576

Authors: Sharon Evans Fatma Ilgaz Anita MacDonald

Background: In phenylketonuria (PKU), the lifelong phenylalanine (Phe)-restricted diet may contribute to altered feeding behaviours and disordered eating. The true prevalence of disordered eating and eating disorders remains uncertain, partly because validated PKU-specific assessment tools are lacking. This systematic review aimed to identify, appraise, and synthesise the evidence on disordered eating and eating disorders in PKU. Methods: Four electronic databases (PubMed, Scopus, Web of Science, and Cochrane) were searched from inception to 24 February 2026. English-language studies reporting disordered eating or eating disorders in early-diagnosed individuals with PKU managed with a Phe-restricted diet, with or without drug therapy, were included. Studies of late- or never-treated patients, pregnancy, lactation, reviews, and preclinical studies were excluded. Two independent reviewers conducted study selection and data extraction. Outcomes included the prevalence of eating disorders, disordered eating behaviours and attitudes, associated factors, and the influence of drug treatment. Findings were synthesised qualitatively, and risk of bias was assessed using the NIH Study Quality Assessment Tools. Results: Twenty-four studies (2928 individuals with PKU) met the inclusion criteria. Most were observational or survey-based. Eating disorders were reported more frequently in PKU (3–13%) than in the general population (n = 4 studies). Common disordered eating features included food neophobia (n = 5 studies), limited food variety (n = 9), food aversion or refusal (n = 5), poor appetite (n = 5), prolonged mealtimes (n = 3), negative parent–child mealtime interactions (n = 6), and specific taste preferences (n = 5). Delayed feeding skill development (n = 6 studies), reduced social eating (n = 6), gastrointestinal symptoms (n = 8), and psychological or neurodevelopmental difficulties (n = 7) were also associated with disordered eating. Early feeding difficulties frequently persisted into adulthood, and longstanding eating behaviours did not consistently improve with pharmaceutical treatment (n = 6 studies). Most studies were rated as fair quality (19/24), with common limitations including small sample sizes, lack of sample-size justification, non-validated assessment tools, and absence of randomised controlled trials. Conclusions: Current evidence suggests that people with PKU experience a greater burden of eating-related difficulties than the general population, although robust estimates of eating disorder prevalence remain lacking. Existing screening tools may misclassify treatment-related dietary behaviours as pathological or fail to identify PKU-specific eating concerns. Development of PKU-specific screening tools could support routine clinical discussions about eating behaviours and the psychosocial impact of dietary treatment, facilitating earlier identification of individuals requiring specialist eating disorder assessment. (Prospero registration: CRD42024539600).

Nutrients doi: 10.3390/nu18152577

Authors: Shiwen Zhou Sha Li Yue Zhao Hu Shi Yueliang Zhao

Background/Objectives: Dibutyl phthalate (DBP) is a ubiquitous environmental plasticizer that has been associated with metabolic dysfunction and steatotic liver injury. Hesperetin, a citrus flavonoid, has reported hepatoprotective properties, but its potential protective mechanisms against DBP-associated steatotic liver injury remain incompletely characterized. Methods: This study integrated network toxicology, network pharmacology, protein–protein interaction analysis, Gene Ontology and KEGG enrichment, molecular docking with redocking validation, sensitivity analysis, and an adverse outcome pathway (AOP) framework to systematically explore the predictive networks linking DBP exposure, MASLD (historically termed NAFLD)-related targets, and hesperetin intervention. Results: The DBP-MASLD network identified TP53, PPARG, TNF, AKT1, and CASP3 as candidate hub targets associated with toxicity, whereas the hesperetin-MASLD network highlighted HSP90AA1, PPARG, ESR1, TNF, and MDM2 as candidate modulatory targets. Integrated pathway analysis indicated that these targets converged mainly on the lipid and atherosclerosis pathway (hsa05417). Triplicate molecular docking, AUC-ROC differentiation validation, and PLIP analysis suggested that Hesperetin (and its glucuronide metabolite) may competitively interact with the exact same active pockets as DBP (and its MBP metabolite). These computational predictions suggest a structural basis for potential interaction, but do not confirm physiological competitive displacement. Conclusions: This in silico study identifies PPARG and TNF as candidate hub targets, providing a structural hypothesis for hesperetin’s potential modulatory effects on DBP-induced steatotic liver injury. These computational predictions establish a theoretical dual-network framework that warrants subsequent in vitro and in vivo experimental validation.

Nutrients doi: 10.3390/nu18152575

Authors: Rosalind T. B. Herrington Zhen Lyu Sarah E. Seda Emmett E. Boling Andrea K. Goldstein Nathan J. Bivens Zhentian Lei Tanhaul Islam Lloyd W. Sumner Trupti Joshi Cheryl S. Rosenfeld

Background: Tryptophan (Trp) is critical to mothers and their conceptuses, and this amino acid is the precursor to serotonin (5-HT). 5-HT modulates placenta function and fetal neurodevelopment. It is not clear if the placenta directly synthesizes 5-HT or uses the serotonin transporter (SERT/Slc6a4) to accrue 5-HT from the dam. The hypothesis tested herein is that reduction in maternal Trp leads to reductions in maternal Trp, 5-HT, and 5-hydroxy-3-indoleacetic acid (5-HIAA, metabolite of serotonin) and reductions in these metabolites within the placenta and fetal brain of female and male conceptuses. Methods: Female mice were placed on a reduced tryptophan (Trp) diet (0.1%) or control diet (0.2%). Diets were provided for two weeks prior to breeding (periconception period) until conceptuses were collected at approximately 12.5 days post-coitus (dpc). Results: While no reductions in maternal Trp and 5-HT were observed, both metabolites were significantly reduced in the placenta and fetal brain of male and female conceptuses (p < 0.05). Female conceptuses were susceptible to reductions in maternal Trp with 549 and 29 transcripts altered in the female placenta and fetal brain, respectively, of reduced Trp dams compared to control dams. Transcriptomic changes, such as reduced expression in Slc6a4 and Slc6a19 (transporter for Trp), in placenta of female conceptuses correlated with reductions in Trp and 5-HT amounts. Conclusions: Findings might have clinical importance to pregnant women as they reveal even subtle reductions in one amino acid profoundly influence conceptus development and might lead to sexual disparity in risk for later diseases, including neurobehavioral disorders.

Nutrients doi: 10.3390/nu18152574

Authors: Carol S. Johnston

Acetate is emerging as an influencer of wellbeing. The interest in acetate parallels the mounting reports of preclinical and small-scale clinical investigations over the past two decades suggesting the health benefits of vinegar, a dietary source of acetic acid along with fermented and pickled foods. Additionally, acetic acid is generated during fermentation by the gut microbiome and is considered a main benefit of the gut microbiome. However, numerous factors adversely impact acetic acid production by gut microbiota such as medications, disease states, and low fiber intakes. Since acetic acid rapidly deprotonates when entering the blood stream, it is a source of systemic acetate. A third source of acetate is endogenous production by various tissues via deacetylation reactions, and endogenous acetate production is 2-fold that generated by microbiota fermentation. This narrative review highlights acetate metabolism and impacts on health parameters as well as the role of vinegar in health promotion as an exogenous source of acetic acid.

Nutrients doi: 10.3390/nu18152573

Authors: Xiaoli Zhang Yusha Li Rongping Luo Haiyun Wang Jing Guo Xiaohan Zhang Manish Kumar Yi Li Jing Liu

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is closely linked to Western dietary patterns. Yet, preclinical studies rely on continuous high-fat feeding, overlooking the intermittent nature of human eating. Whether dietary periodicity itself influences the gut–liver axis and MASLD pathogenesis remains unknown. We compared continuous and intermittent high-fat, high-cholesterol (HFHC) diets in guinea pigs, a model that mirrors human lipoprotein metabolism, hepatic cholesterol handling, and hindgut fermentation. Methods: Integrated multi-omics analyses (serum metabolomics, fecal 16S rRNA sequencing, and liver transcriptomics) were employed in a guinea pig model, stratified into normal diet (ND), intermittent HFHC diet (IHD), and IHD with flaxseed lignan supplementation, to compare the effects of dietary regimens and the therapeutic efficacy of lignan on hepatic pathology. Results: Both diets induced hallmark hepatic features of MASLD; however, the intermittent regimen provoked significantly more severe hepatic steatosis, inflammation, oxidative stress, and fibrosis. Hepatic transcriptomic analysis identified the PI3K-Akt signaling pathway as the most significantly enriched pathway in the IHD group. Mechanistically, this aggravated liver injury was linked to gut microbiota dysbiosis and a marked depletion of the microbial metabolite enterolactone. Fecal microbiota transplantation confirmed that the dysbiotic microbiota directly transmits the aggravated liver injury phenotype. Supplementation with flaxseed lignan, the dietary precursor of enterolactone, restored enterolactone production, corrected the dysregulated gut microbiota–enterolactone axis, and largely normalized the expression of PI3K-Akt downstream targets, thereby alleviating hepatic pathology. Conclusions: These findings suggest that alterations in the gut microbiota–enterolactone axis may contribute to diet-periodicity-driven liver injury and highlight its potential involvement in disease progression. Modulating this axis through dietary interventions, such as flaxseed lignan supplementation, may represent a promising nutritional strategy for mitigating MASLD associated with cyclical dietary exposure.

Nutrients doi: 10.3390/nu18152572

Authors: Raluca-Gabriela Miulescu Ioana Roşca Ruxandra-Cristina Marin Călin Muntean Alexandru-Neculai Pavel Smaranda Stoleru Andreea Teodora Constantin Elena Poenaru Oana Andreea Parliteanu Daniela Eugenia Popescu Oana Andreia Coman

Background/Objectives: Atopic dermatitis (AD) is a chronic inflammatory skin disease in which gut–skin axis dysregulation is increasingly implicated. We conducted a prospective pilot study to describe the clinical evolution of pediatric AD following individualized, stool-guided microbiota-targeted therapy and to explore whether baseline dysbiosis markers predict outcomes beyond baseline disease severity. Methods: Twenty-one children with AD and laboratory-confirmed gut dysbiosis were enrolled consecutively at a tertiary pediatric center in Romania in a single-arm prospective pilot study. Gut microbiota was assessed using targeted culture-based stool analysis, generating a Flora Index and a binary High Putrefaction Flora classification. Individualized treatment consisted of strain-specific probiotics, prebiotics, and antifungals when indicated. Disease severity was assessed using the Patient-Oriented Eczema Measure (POEM) and Scoring Atopic Dermatitis (SCORAD) at baseline, 30 days, and 90 days. Longitudinal changes were evaluated using repeated-measures ANOVA and hierarchical regression models. Results: High Putrefaction Flora was present in 71.4% of participants. Mean POEM decreased from 14.67 ± 5.22 at baseline to 7.10 ± 3.82 at 90 days, while mean SCORAD decreased from 41.66 ± 15.28 to 17.93 ± 11.68 (both p < 0.001). Approximately 76% of participants achieved a ≥50% reduction in POEM, and 71% achieved a ≥50% reduction in SCORAD. Individualized microbiota-targeted therapy was associated with substantial improvements in both clinical and patient-reported disease severity over the 90-day follow-up. Although children with High Putrefaction Flora exhibited higher disease severity scores in unadjusted analyses, baseline disease severity was the only significant predictor of 90-day outcomes. The Flora Index provided no independent explanatory value. Conclusions: In this exploratory single-arm pilot study, individualized microbiota-targeted therapy was associated with substantial and clinically meaningful improvement in AD severity over 90 days. Dysbiosis markers were associated with disease burden but did not independently predict outcomes, suggesting that they may function primarily as indicators of baseline severity rather than prognostic biomarkers. Because of the uncontrolled study design, causal inferences regarding treatment effects cannot be made, and these findings should be considered hypothesis-generating. Adequately powered randomized controlled trials are required to determine the efficacy of individualized microbiota-targeted interventions in pediatric atopic dermatitis.

Nutrients doi: 10.3390/nu18152571

Authors: Claudia E. Lazarte Rucha Rane Frida Hållenius Olena Prykhodko

Background: The global shift to sustainable diets has raised interest in plant-based protein sources, particularly pulses, due to their nutritional value, health benefits, and low environmental impact. Pulses are rich in protein, dietary fiber, and a variety of bioactive compounds that may influence gut microbiota and metabolic health. Objective: This narrative review aims to evaluate the role of pulse consumption in modulating gut microbiota, improving metabolic health, and contributing to the prevention of non-communicable diseases (NCDs), while considering the impact of processing techniques such as fermentation and sustainability aspects. Methods: A comprehensive literature search was conducted using major scientific databases to identify relevant studies published during the last 10 years. Evidence from in vitro, in vivo experimental and human studies was included, focusing on pulse composition, bioactive compounds, gut microbiota modulation, metabolic outcomes, and the effects of processing methods such as fermentation. Results: Pulses demonstrate promising potential to improve gut health by promoting beneficial microbiota, increasing short-chain fatty acid production, and enhancing intestinal barrier function. Evidence also suggests favorable effects on lipid metabolism, glycemic control, and inflammation. Processing techniques, particularly fermentation, improve nutrient bioavailability, digestibility, and bioactive profiles. Beyond health outcomes, this review places pulses in the larger context, emphasizing their contribution to healthy, sustainable diets. Conclusions: Pulses are key components for achieving sustainable, health-promoting diets with promising effects on gut and metabolic health. However, current evidence is largely derived from preclinical studies, highlighting the need for long-term human interventions and scalable processing strategies to fully realize their potential.

Nutrients doi: 10.3390/nu18152570

Authors: Ye (Flora) Wang Zhongqi Fan Sandra Marsden Chiara DiAngelo Laura Chiavaroli Mavra Ahmed Mei Chung

Background/Objectives: There is continuing debate regarding the association between added sugars (AS) consumption and overall diet quality, which remains a research gap within the Canadian population. This study aimed to assess the association between intakes of added sugars and the Healthy Eating Food Index (HEFI) 2019 that measures adherence to Canada’s Food Guide as an indicator of diet quality. Methods: The first 24 h dietary recalls of Canadians 2 years and older (n = 19,532) from the 2015 Canadian Community Health Survey—Nutrition were used. Added sugars intakes were calculated based on a systematic 10-step algorithm. Descriptive statistics were obtained for total HEFI and component scores across different AS intake categories. The association between AS categories and HEFI scores was tested using a generalized linear model adjusted for age, sex, education level, type of smoker, and misreporting status. Results: The association between continuous AS intake and HEFI scores was non-linear. In the categorical model, AS intake categories were inversely associated with HEFI scores among Canadians (R2 = 0.32, p < 0.001). Large overlaps in HEFI scores were observed among individuals with similar AS intakes for the whole population and each age group. Among high AS consumers (>15% EI), lower HEFI scores were largely due to higher proportions of sweetened beverages (i.e., low beverage scores) and lower intakes of vegetables and fruit and plant-based proteins. Scores for protein food and whole grains were low across all AS intake categories. Conclusions: Large variations in overall HEFI scores were observed amongst those with similar AS intakes, suggesting that added sugars alone may not fully capture overall diet quality or adherence to Canada’s Food Guide.

Nutrients doi: 10.3390/nu18152569

Authors: Yile Peng Yalin Zhou Simon Bøge Riis Jing Yin Muke Han Zhang Wen Wanyun Ye Xudong Liu Weiwei Shi Xuezeng Wang Jiahui Luo Yajun Xu

Objective: To investigate the effect of milk minerals on bone mineral density (BMD) and bone quality in growing rats and explore the underlying mechanisms related to calcium absorption, bone metabolism, and the gut–bone axis. Methods: Sixty healthy 4-week-old male Sprague-Dawley (SD) rats were randomly divided to five groups based on their body weight: Low-Calcium Control Group (Control), Low-Dose milk mineral Group (Low), Medium-Dose milk mineral Group (Medium), High-Dose milk mineral Group (High) and Calcium Carbonate Control Group (CaCO3), which received the same dose level (elemental calcium) as the High group. The milk mineral dosage was set at 5, 10, and 15 times the human recommended intake of elemental calcium. After 12 weeks of intervention, femurs were collected for analysis of BMD, bone microstructure, and bone mechanical strength. Additionally, analyses included calcium levels in the femur, feces, and diet; serum bone metabolism biomarkers; tissue protein expression; as well as gut microbiota composition and short-chain fatty acid content. Result: Milk mineral exhibited non-inferior efficacy to CaCO3 in increasing femoral calcium content, enhancing BMD, and improving bone microarchitecture. Notably, the Medium group achieved comparable bone-protective effects to the CaCO3 group despite a 20.8% lower calcium content, which was accompanied by a relatively high calcium absorption rate (90.9% vs. 86.5%). With respect to serum markers, milk mineral maintained bone formation while suppressing bone resorption, resulting in a net anabolic state comparable to that of CaCO3. Milk mineral significantly upregulated the protein expression of renal CYP27B1 and intestinal calcium ion transporters, and increased serum IGF-I levels. Furthermore, milk mineral promoted the enrichment of certain specific gut microbial genera, which showed a significant positive correlation with IGF-I, bone calcium content and BMD. Conclusions: Milk mineral supplementation appears to promote bone formation and mineralization in growing rats, accompanied by enhanced intestinal calcium absorption, enrichment of characteristic gut microbes and elevated microbial metabolite concentrations.

Nutrients doi: 10.3390/nu18152568

Authors: Umberto Tarantino Chiara Greggi Beatrice Gasperini Manuel Scimeca Riccardo Iundusi Elena Gasbarra Maria Luisa Brandi

Phosphate accounts for about 0.6% of body weight at birth and about 1% of body weight in adults. This anion is essential for the performance of many essential human cellular processes, including energy metabolism and cell signaling; it is also a key component of the phospholipid bilayer and nucleic acids structure. In addition, phosphate is responsible for maintaining acid-base balance within the cells, functioning of the nervous system and preserving bone integrity. Normal serum phosphate levels change throughout life, varying from the neonatal period, through adolescence, and stabilizing at adult values by the end of puberty. Serum phosphate homeostasis is maintained through dietary intake, intra- and intercellular shifts, and excretion/absorption/reabsorption processes mediated by Fibroblast Growth Factor 23, parathyroid hormone, and 1,25-(OH)2D3. Within this homeostatic network, dietary sources and current population-based intake data highlight a widespread oversupply in modern diets that can influence chronic disease outcomes. Ultimately, alterations in serum phosphate concentrations lead to numerous pathological conditions, both congenital and acquired. These conditions may involve either hypo- or hyperphosphatemia, each characterized by a wide spectrum of clinical manifestations, some of which primarily affect the musculoskeletal system. Starting from this evidence, the primary purpose of this review is to examine the phosphate-related pathological conditions from biological-molecular and clinical perspectives, while also considering targeted nutritional and clinical strategies for managing phosphate balance. Algorithms for management and differential diagnosis are also considered, thus providing a recent overview of a medical field that is becoming increasingly important for clinicians.

Nutrients doi: 10.3390/nu18152566

Authors: Jinpeng Wang Rui Wang Fan Yang Wenfeng Wang Ruifang Shen Siyu Jiang Qiao Li Qiuxin Yan Yinghui Li Yan Diao Lijun Wei

Background: Prolonged exposure to microgravity during spaceflight leads to significant bone loss. The phenomenon of weightlessness-induced bone loss (WIBL) continues to intensify as the flight time increases and this has attracted considerable attention of scholars. Methods: In this study, proteomic analysis was performed to identify potential signaling pathways involved in WIBL. Subsequently, the effectiveness of Atractylodes macrocephala polysaccharide (AMP) 1-1 on WIBL was investigated using a rat hindlimb suspension (HLS) model and a co-culture model of osteoblasts and RAW264.7 cell line. Results: It was found that AMP1-1 treatment improved bone microarchitecture, reduced the bone transformation rate, and enhanced bone biomechanical properties in the HLS model. In the cell co-culture system, AMP1-1 significantly inhibited osteoclastic differentiation, promoted osteoblastic differentiation, and attenuated osteoblastic apoptosis. The interaction between the nuclear factor erythroid 2-related factor 2 (Nrf2) system and antioxidant enzymes represented a key pathway mediating WIBL. Further investigation confirmed that AMP1-1 facilitated the nuclear translocation of Nrf2, up-regulated heme oxygenase-1 protein expression, and enhanced the transcription of downstream antioxidant enzymes. Consequently, it maintained bone homeostasis and protected against bone loss. Conclusions: Our findings demonstrate that AMP1-1 protects against WIBL by modulating the Nrf2 pathway and suppressing oxidative stress, offering a potential therapeutic strategy for mitigating bone loss in weightless environments.

Nutrients doi: 10.3390/nu18152567

Authors: Paraschiva Chereches-Panta Claudia Felicia Pop Ioana Corina Bocșan Orlanda Moldovan Alina-Petronela Bouari-Coblișan Marcela Daniela Ionescu Valentina Sas

Introduction: Asthma is the most common chronic inflammatory disease in childhood, with complex pathogenesis and heterogeneous clinical manifestations. Current efforts are focused on achieving remission through phenotyping and personalized therapy. Micronutrient deficiency is commonly observed in both children and adults, and current evidence points to their role in the pathogenesis of numerous acute and chronic conditions. Method: In this narrative review, we analyzed current information regarding the influence of micronutrient deficiencies on asthma control. The aim was to clarify the extent to which current knowledge provides evidence for implementing specific dietary measures in children with asthma to achieve disease control. We conducted a review of the literature covering the past 20 years to assess the impact of iron, vitamin D, and folic acid deficiency on asthma control. The research was performed in PubMed, Web of Science, Cochrane Library and Embase. Results: Vitamin D deficiency is associated with the frequency of asthma exacerbations in children. However, data regarding the severity of exacerbations, hospitalizations, or emergency department visits are not consistent across different studies. Vitamin D supplementation has controversial effects on disease control. Iron deficiency may contribute to the development of asthma, but there is no clear evidence. Observational studies have reported associations between iron deficiency, poorer asthma control, frequent exacerbations, and impaired lung function. An association between low folate levels and increased asthma risk and poorer asthma control was also reported. Conclusions: Assessing micronutrient status in children with asthma and the effect of correcting deficiencies as part of a personalized treatment plan to achieve symptom control remains a topic that requires further research.

Nutrients doi: 10.3390/nu18152565

Authors: Silvio Borrelli Carlo Garofalo Tino Paolo Ambrosino Vincenzo Bellizzi Simona Andriella Federica Marzano Roberta Germanò Chiara Ruotolo Gianfranca Cabiddu Roberto Russo Valerio Vizzardi Diana Bertoni Adamasco Cupisti Loris Neri Gaetano Alfano Gennaro Argentino Silvia D’Alonzo Paolo Chiodini Giuseppe Paribello Francesco Trepiccione Roberto Minutolo Luca De Nicola I-COPE Group I-COPE Group

Background: Commencing peritoneal dialysis (PD) with a lower dose (incremental PD) is a common strategy to improve patient acceptance and reduce treatment burden. However, specific dietary protein recommendations for incremental PD are lacking. Methods: An interim analysis of the I-COPE PD study cohort aimed to assess one-year changes in serum albumin, body mass index (BMI), and metabolic parameters in a cohort of patients on incremental PD. Following local protocols, patients were categorized into two groups according to protein diet prescription: protein diet (PrD) ≤ 0.6 and PrD > 0.6 g/kg/day. Longitudinal changes at baseline, 6 and 12 months were analyzed using mixed-effects models adjusted for age, sex, diabetes, residual kidney function and serum albumin at baseline. Results: We included 205 patients (mean age 63.3 ± 14.2 years; 66% male; 30% diabetes; 92.2% CAPD) and in 45.4% a PrD ≤ 0.6 g/kg/day was prescribed. Baseline demographic, clinical, lab and therapeutic characteristics were well-balanced between the two diet groups. After one year of follow-up, the prevalence of patients persisting in incremental PD was not different between the two dietary groups (59.1% in PrD ≤ 0.6 vs. 63.3% in PrD > 0.6, log-rank test = 0.759), and both groups showed a similar trend in serum albumin, characterized by an initial decline followed by stabilization (p = 0.647), with no significant differences in BMI (p = 0.461). Despite comparable dialysis adequacy, patients on PrD ≤ 0.6 exhibited significantly lower serum urea, phosphate, and potassium levels over time compared to the PrD > 0.6 group. Conclusions: In patients starting incremental PD, the prescription of a lower protein diet could be associated with better control of uremic toxins, while serum albumin levels over time remain comparable to those observed in patients under a higher-protein diet.

Nutrients doi: 10.3390/nu18152564

Authors: Wenhao Hao Yuxin Zhao Huimin Cui Andong Liu Wei Gong Kangling Wang Hong Lin Lei Hao Fanfan Han Jianjun Yang

Background: Non-invasive therapies for heart failure represent one of the current major focuses in clinical research. Plant-derived extracellular vesicles (PEVs) have recently emerged as a promising therapeutic modality. Objectives: In this study, we investigated the therapeutic potential of PEVs in heart failure with preserved ejection fraction (HFpEF), focusing on extracellular vesicles derived from Lycium barbarum (Gq-EVs). Methods: We first obtained Gq-EVs with high biological activity and high concentration from Lycium barbarum juice and characterized them by using transmission electron microscopy, nanoparticle tracking analysis, and metabolite composition analysis. Results: Our in vivo findings indicate that nebulized inhalation of Gq-EVs for 7, 14, and 21 days improved abnormal cardiac diastolic function, reduced excessive myocardial hypertrophy, and attenuated inflammatory cell infiltration and collagen deposition in HFpEF mice. Further in vivo and in vitro experiments showed that Gq-EVs can reach injured cardiac tissue, improve mitochondrial function, and are associated with reduced cardiomyocyte apoptosis and amelioration of myocardial hypertrophy, potentially involving TP53-related apoptotic signaling. Conclusions: Overall, nebulized delivery of Gq-EVs may be a relatively non-invasive, well-tolerated, and cost-effective therapeutic strategy for HFpEF, highlighting the potential of PEV-based nanotherapies and offering a sustainable approach for the medical utilization of Lycium barbarum resources.

Nutrients doi: 10.3390/nu18152563

Authors: Ceren Alis Ezgi Uludüz Sevim Eyüpoğlu Mustafa İskender Onur Öztornacı Aynur Özge Derya Uludüz

Background: Dietary factors may influence migraine burden, but the relationship between Mediterranean diet (MD) adherence and migraine chronicity remains unclear. This study aimed to investigate whether higher MD adherence is associated with a less severe migraine phenotype, particularly lower odds of chronic migraine (CM) and fewer monthly headache days. Methods: This retrospective observational study included 448 patients diagnosed with migraine who were classified as having episodic migraine (EM) or CM. MD adherence was assessed using the validated Turkish version of the 14-item Mediterranean Diet Adherence Screener (MEDAS). Participants were categorized as having poor adherence (scores 0–5) or at least moderate adherence (scores 6–14). Demographic characteristics, migraine features, comorbidities, medication overuse, daily water intake, caffeine intake, sweetened carbonated beverage intake, and dietary behaviours were retrieved from patient files. Logistic regression models were used to evaluate the association between MD adherence and CM. Negative binomial regression was used for monthly headache days. Results: Of 448 patients, 256 had EM and 192 had CM. Patients with CM had lower MEDAS scores than those with EM and were less likely to have moderate-to-high MD adherence. Higher MD adherence was independently associated with lower odds of CM after adjustment for age, sex, BMI, disease duration, comorbidities, medication overuse, water intake, caffeine intake, and broader dietary behaviours (OR = 0.360, 95% CI: 0.193–0.674, p = 0.001). This association persisted after excluding patients with medication overuse, after multiple imputation, and when MEDAS was analysed continuously. Higher MD adherence was also associated with fewer monthly headache days in unadjusted and clinically adjusted models; however, this association was attenuated after full adjustment for caffeine intake and other dietary behaviours. Conclusions: Higher MD adherence was independently associated with lower odds of CM, even after adjustment for medication overuse and lifestyle-related dietary factors. The association with monthly headache days appeared more sensitive to broader dietary behaviours. These findings support the role of MD adherence as a potentially relevant lifestyle marker of migraine chronicity and warrant prospective studies that use detailed dietary assessment.

Nutrients doi: 10.3390/nu18152562

Authors: Shengxuan Li Min Pi Zhuoxin Yang Xiaoming Ma Jinjun Yuan Yumei Zhou

Background: Postpartum depression (PPD) is a prevalent and debilitating disorder, with increasing evidence implicating the gut microbiota–brain axis. However, integrated alterations in gut microbiota and circulating metabolites in PPD remain insufficiently characterized. Methods: Fecal and serum samples were collected from patients with PPD and healthy controls (HC). Depressive symptoms were assessed using the 17-item Hamilton Depression Rating Scale (HAMD-17). Gut microbiota was analyzed by 16S rRNA sequencing, and serum metabolites were profiled using untargeted LC–MS-based metabolomics. Spearman correlation and receiver operating characteristic (ROC) analyses were performed. Results: A total of 63 participants (42 PPD, 21 HC) were included. Significant alterations in gut microbial composition were observed in PPD, including decreased Faecalibacterium and Akkermansia and increased Ralstonia and Fusobacterium. Candidate differential serum metabolic features, including LPE-related and energy-metabolism-related features, were identified. Exploratory correlation analyses suggested distinct microbiota–metabolite association patterns, and several microbial taxa and serum metabolic features were associated with HAMD-17 scores. ROC analysis showed that several taxa and metabolic features exhibited preliminary discriminative performance with this cohort, although further validation is required. Conclusions: PPD was associated with alterations in gut microbiota composition and exploratory circulating metabolite profiles, potentially involving lipid dysregulation, neuroinflammation, steroid-related metabolism, and neurotoxicity-related pathways. The identified taxa and putatively annotated metabolites should be regarded as exploratory PPD-associated candidates rather than validated biomarkers or mechanistic mediators. Further validation in larger, independent cohorts is warranted. These findings may also inform future microbiota- and nutrition-oriented strategies for postpartum mental health management.

Nutrients doi: 10.3390/nu18152561

Authors: Matteo Briguglio Thomas W. Wainwright

The treatment of osteoarthritis (OA), a leading cause of disability worldwide, is increasingly integrating nutritional strategies that appear to offer the opportunity to significantly improve the quality of care. Patients are also aware of this and often seek clarification and advice from OA professionals. However, it is still too early to formulate definitive recommendations, as the scientific evidence is still heterogeneous. This can create a gap between patients’ need for clear guidance and the necessarily prudent communication of professionals. As a result, some patients may make decisions on their own, forgoing the opportunity to receive nutritional care personalised according to their dietary habits and disease severity. This commentary presents an expert interpretation of the currently available evidence and proposes a practical framework to support clinical discussions with patients. It is not intended as a formal clinical practice guideline but aims to help OA professionals navigate conversations about the role that nutritional strategies may play in disease management.

Nutrients doi: 10.3390/nu18152560

Authors: Karolina Kujawowicz Iwona Mirończuk-Chodakowska Monika Cyuńczyk Anna Maria Witkowska

Background/Objectives: Malnutrition in older adults constitutes a significant public health concern, reflecting a multifactorial risk and demonstrating the necessity of early identification in geriatric care. This preliminary study aimed to explore whether an unsupervised machine learning (ML) approach based on hierarchical clustering on principal components (HCPC) could help characterize multidimensional phenotypes associated with malnutrition risk in older adults. Methods: This exploratory cross-sectional study included 105 older adults, aged 60–95 years, recruited from community and residential care settings. Anthropometric measurements, body composition, nutritional status, depressive symptoms, physical and functional fitness, frailty, sarcopenia, appetite, and biological and hematological parameters were evaluated. The statistical analyses were performed using ML combining Multiple Factor Analysis (MFA) for dimensionality reduction and HCPC for cluster identification. Results: HCPC identified three distinct phenotypes. Cluster 1 represented a relatively preserved nutritional and geriatric phenotype with lower frailty, residential care, and disease burden. Cluster 2 was a male-dominant group with preserved muscle mass and functional reserve. Cluster 3 was the most vulnerable phenotype, characterized by higher malnutrition risk, frailty, polypharmacy, depressive symptoms, and poorer functional status, with the strongest links observed for body composition, muscle mass, grip strength, malnutrition risk, frailty risk, and functional performance. Conclusions: This preliminary study suggests that unsupervised machine learning may help characterize geriatric and nutritional profiles associated with malnutrition risk in older adults. Higher malnutrition risk was observed in the profile characterized by greater multidimensional vulnerability, warranting cautious interpretation and validation in larger cohorts.

Nutrients doi: 10.3390/nu18152559

Authors: Chikondi Maluwa Blecious Zinan’dala Praporn Kijkuokool Puriwat Fakfum Churdsak Jaikang Giatgong Konguthaithip Wason Parklak Hataichanok Chuljerm Kanokwan Kulprachakarn

Background/Objectives: Watercress (Nasturtium officinale R.Br.) is a glucosinolate-rich cruciferous vegetable with reported cardioprotective properties. However, previous human studies have relied on targeted clinical and biochemical biomarkers, limiting insight into its broader metabolic effects. This exploratory study investigated plasma metabolomic changes associated with watercress supplementation in adults with low-to-moderate cardiovascular risk using untargeted proton nuclear magnetic resonance (1H-NMR) spectroscopy. Methods: In this randomized, single-blind, placebo-controlled pilot trial (Thai Clinical Trials Registry: TCTR20251119004), 26 participants aged 40–59 years received dried watercress capsules (8 g/day; approximately 195 mg glucosinolates/day) or placebo for 28 days. Fasting plasma samples collected at baseline and Day 28 underwent untargeted 1H-NMR profiling. Partial least squares-discriminant analysis (PLS-DA) assessed group discrimination, while Kyoto Encyclopedia of Genes and Genomes (KEGG)-based pathway enrichment and topology analyses identified perturbed metabolic pathways. Results: A total of 209 plasma metabolites were identified. PLS-DA demonstrated modest discrimination between groups (Q2 = 0.268), with 27 discriminant metabolites (variable importance in projection > 1.5) involving amino acid, nucleotide, carbohydrate, and gut microbial metabolism. Eighteen metabolic pathways were significantly perturbed, particularly galactose and fructose/mannose metabolism (p < 0.001), together with glycerolipid, purine, glycolysis/gluconeogenesis, and tryptophan metabolism. Watercress supplementation reduced metabolites associated with oxidative DNA damage, inflammatory kynurenine metabolism, and microbial co-metabolism, while increasing glycine and dimethylglycine and altered gut microbial activity. Conventional biomarkers showed a significant decrease in low-density lipoprotein cholesterol but no consistent effects on other lipids. Conclusions: Watercress supplementation was associated with coordinated metabolic alterations across multiple pathways, generating mechanistic hypotheses for its antioxidant and cardiometabolic effects. These findings are exploratory and warrant confirmation in larger, adequately powered clinical trials.

Nutrients doi: 10.3390/nu18152558

Authors: Rowena Thekkekara Anupama Bangra Kulur Jamie Seymour Haleagrahara Nagaraja

Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease defined by persistent synovial inflammation, progressive cartilage and bone erosion, and extra-articular manifestations. Current treatments, such as disease-modifying anti-rheumatic drugs (DMARDs), glucocorticoids, and non-steroidal anti-inflammatory drugs (NSAIDs), control disease activity but are limited by toxicity, reduced response over time, and are expensive, demonstrating the need for safer and more effective adjuncts. The marine environment is a rich, largely untapped source of structurally diverse bioactive molecules that could be used to develop new therapeutics. This review compiles current evidence on anti-inflammatory and immunomodulatory compounds from marine organisms relevant to RA, including macroalgae, true marine microalgae, marine microorganisms (bacteria and fungi, including deep-sea taxa), sea cucumbers, sponges, mussels, corals, and jellyfish. Recurring mechanisms of action include inhibition of the NF-κB, MAPK, and JAK/STAT signalling cascades; suppression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2); reduced production of tumour necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6; and activation of the Nrf2 antioxidant response. Particular attention is given to functional lipids (eicosapentaenoic and docosahexaenoic acids, prostaglandin-like oxylipins) and pigments (astaxanthin, fucoxanthin, β-carotene) from marine microalgae and heterotrophic protists, which recent literature identifies as the most clinically advanced marine leads. To clarify translational status, compounds are grouped by their development stage (marketed nutraceutical, clinical trial, or preclinical) and summarised in a dedicated table. Some compounds, such as green-lipped mussel extract, microalgal omega-3 oils, and astaxanthin, have reached the stage of randomised controlled trials for arthritis. However, most other potential treatments are still in the early, preclinical phase. It is worth noting that ocean-derived compounds appear generally safe, but more thorough studies, especially in living organisms and in clinical settings, are needed to confirm their effectiveness for rheumatoid arthritis before any claims can be made about their therapeutic benefits.

Nutrients doi: 10.3390/nu18152557

Authors: Michelle Yavelow Athanasios Tsalatsanis Marisa Couluris Danielle Reynolds Racha T. Khalaf

Background/Objectives: The prevalence of obesity in cystic fibrosis (CF) has increased following the introduction of highly effective modulator therapy (HEMT). However, the impact of increased adiposity on the lung function of pediatric patients with CF (ppwCF) in the era of HEMT remains incompletely understood. Furthermore, while the body mass index (BMI) is the most commonly used nutritional marker in CF care, it has important limitations and may not accurately reflect body composition. Methods: In this cross-sectional pilot study, ppwCF aged 5–18 years completed Bioelectrical Impedance Analysis (BIA) while a subset completed a dual-energy X-ray absorptiometry (DXA) scan and spirometry. Normality was assessed using Shapiro–Wilk tests. Correlations, categorical association, agreement tests, Firth penalized logistic regression, and exploratory linear regression of continuous FEV1% predicted were used to examine relationships among anthropometric measurements, body compositions, and pulmonary function. Results: Thirty-four individuals completed study procedures (19 female (56%); mean age 9.85 (SD 3.58)). BIA and DXA-derived body fat percentages were strongly correlated, and categorical agreement was moderate (Cohen’s Kappa 0.574; p-value 0.005). In age and sex-adjusted linear regression, BIA fat percentage (β = −0.23; 95% CI, −1.09 to 0.64; p = 0.595) and DXA fat percentage (β = −0.47; 95% CI, −2.14 to 1.21; p = 0.552) were not significantly associated with FEV1% predicted. Similarly, Firth logistic models showed no statistically significant association between the adiposity category and reduced lung function. Conclusions: BIA-derived body fat measurements correlate with DXA-derived measurements in ppwCF and demonstrate feasibility for use in routine CF clinic visits. This pilot cohort did not show a statistically significant relationship between higher adiposity and poorer pulmonary function. However, the wide confidence intervals indicate substantial uncertainty. Larger prospective studies are needed to evaluate longitudinal relationships between body composition and lung function in the HEMT era.

Nutrients doi: 10.3390/nu18152555

Authors: Christian Viel Ying Shi Ryan P. Trueman Arnaud J. Ruiz Melissa L. D. Rayner

Background: Peripheral neuropathy (PN) is one of the most common disorders of the peripheral nervous system, affecting around 10% of the general adult population. PN results in pain, paraesthesia, and sensory loss, negatively impacting patients’ quality of life. The condition is characterised by damage to peripheral nerves and is often linked to risk factors, among which diabetes is the most common cause. The incidence rate of patients suffering from PN has significantly increased in the last three decades, yet there are currently no pharmacological treatments to reverse or prevent the development of PN. Therefore, neurotropic B vitamins, specifically vitamins B1, B6, and B12, which are essential for protecting nerves from damage, nerve regeneration, and maintaining nerve health, are promising treatment options. Other biofactors with therapeutic potential are vitamin D3, which has been described as a regulator of neuroplasticity and neuroinflammation with indications to promote neuronal regeneration following injury, as well as alpha-lipoic acid (ALA), a well-described treatment option in PN. Methods: The regenerative capacity of vitamins B1, B6, B12, and D3 and ALA was determined following neurite degeneration in vitro induced by either hydrogen peroxide (H2O2) or homocysteine. Results: In line with previous studies, the results show that a combination of vitamins B1, B6, and B12 has a significantly better effect on neurite extension following homocysteine-induced degeneration. In H2O2-insulted neural cells, the combination of all three neurotropic B vitamins was also shown to be superior to that of individual B vitamin treatment, demonstrated by longer neurite length after insult. Vitamin D3 also demonstrated a neuro-regenerative effect on neurites in healthy and insulted neural cells, whereas ALA only appears to provide a protective effect, preventing ongoing damage and supporting neurite outgrowth in healthy cells. No synergistic effects were seen with any treatment combinations. Conclusions: We have established an in vitro model of homocysteine-induced degeneration, and using this model alongside H2O2-induced degeneration, we provide evidence of the neurite regenerative capacity of vitamins B1, B6, B12, and D3.

Nutrients doi: 10.3390/nu18152556

Authors: Vishakha Modak Aditya Karthikeyan Natali Sorajja Sridhar Mangalesh Priyansh Shah Sharanya Kaushik Eleonora Gashi Robert Faillace

Background: Pediatric cardiometabolic health in the United States is declining, driven by rising rates of obesity, prediabetes, and type 2 diabetes. School lunch programs provide a unique opportunity to influence children’s dietary behaviors, reaching millions of students across diverse socioeconomic backgrounds each day. Increasing the availability of plant-based meals in school lunch programs may help reduce modifiable cardiometabolic risk factors and serve as a cost-effective, population-level strategy to promote long-term cardiovascular health. Methods: We conducted a cross-sectional narrative policy review of school lunch programs across all 50 U.S. states and the District of Columbia. Publicly available state statutes, regulations, school nutrition guidance, government reports, and educational resources were systematically reviewed to identify official statewide policies or guidance explicitly supporting plant-based or vegetarian meals. Jurisdictions were classified as providing either Explicit Support or Not Specified according to predefined coding criteria. We also assessed whether jurisdictions specified the frequency of plant-based meal offerings. Results: Only 3 of 51 jurisdictions (5.9%)—California, the District of Columbia, and Illinois—provided explicit statewide support for plant-based meal options. The remaining 48 jurisdictions (94.1%) did not explicitly promote or support plant-based meals in official statewide school nutrition policies or guidance. No jurisdiction mandated the frequency of plant-based meal offerings, although the District of Columbia provided non-binding guidance encouraging regular inclusion. Conclusions: Explicit statewide support for plant-based or vegetarian school meals remains rare in the United States. Strengthening state-level policies and developing standardized guidance on the inclusion and frequency of plant-based meals in school lunch programs may represent a feasible population-level strategy to improve dietary quality and reduce future pediatric cardiometabolic risk.

Nutrients doi: 10.3390/nu18152554

Authors: Fatimah Alenazi Hend F. Alharbi

Background/Objectives: Mukbang videos have become increasingly popular and may be associated with eating behaviors, particularly among university students who are more susceptible to stress-related eating and social media use. Evidence on the relationship between Mukbang addiction and emotional eating is limited. This study investigated the association between Mukbang addiction and emotional eating among university students in Saudi Arabia. Methods: A cross-sectional study was conducted between November 2025 and April 2026 using an online questionnaire. A total of 551 students completed the survey. Data were analyzed using descriptive statistics, chi-square tests, and multiple linear regression. Results: Emotional Eating Questionnaire (EEQ) and Mukbang Addiction Scale (MAS) scores did not differ significantly by age, gender, education, or income. EEQ scores differed significantly by marital status (p = 0.025) and occupation (p = 0.037), while MAS did not. Both EEQ and MAS were significantly associated with BMI (p < 0.05). Descriptive analysis showed that participants with high emotional eating levels had a greater proportion of high Mukbang addiction (55%) compared with low Mukbang addiction (45%). However, multiple linear regression analysis found no significant association between EEQ and MAS scores (B = 0.275, p = 0.249). Additionally, MAS scores were not significantly associated with any demographic characteristics. Conclusions: BMI was significantly linked to both emotional eating and Mukbang addiction. Longitudinal studies are needed to clarify these relationships and inform interventions promoting healthier eating behaviors among university students.

Nutrients doi: 10.3390/nu18152553

Authors: Shannon Freeman Santiago Otalvaro Zapata Emma Rossnagel Atefeh Panahi

Background/Objectives: Limited access to fresh produce and persistent nutrition risk in long-term care (LTC) can affect dietary quality and rehabilitation capacity, particularly where seasonality and supply constraints affect food environments. Indoor hydroponic systems may support on-site production of leafy greens and herbs, but their adoption depends on practical feasibility. This study evaluated the routine staffing time and labour-only costs associated with maintaining hydroponic green wall units in LTC settings. Methods: A prospective, multi-site observational quantitative service evaluation was conducted from March 2023 to September 2024 across four LTC settings in Western Canada. Staff and volunteers logged routine interactions with wall-mounted hydroponic green wall units using adjacent mounted iPads. Entries captured task type(s), duration, using prespecified time categories, and staff role. Descriptive analyses summarized entries and actions by role and site. Labour costs were estimated using province-specific wage bands. Workload and costs were normalized using active weeks as weeks with ≥1 logged interaction. Results: A total of 112 log entries were recorded, corresponding to 362 logged actions and 962.0 min of recorded staff engagement time. Recreation therapists/dietitians submitted 45.5% of entries (n = 51), followed by care aides (27.7%, n = 31), volunteers (17.0%, n = 19), management (7.1%, n = 8), and registered nurses (2.7%, n = 3). Actions were dominated by monitoring and routine maintenance; 36.0% of time-recorded interactions were 0–5 min. Mean engagement was 8.7 min per time-recorded entry. Normalized to 59 active site-weeks, average workload was 16.3 min per active site-week (range 11.8–21.3), with labour-only costs of approximately 7.24 CAD per week (5.96–8.34) and 28.9 CAD per 4-week month (23.84–33.36). Conclusions: Routine upkeep of hydroponic green wall units required modest, predictable staff time and low labour-only costs, with responsibilities largely distributed across non-registered nurse roles. These findings provide feasibility parameters relevant to sustaining hydroponics as an enabling infrastructure component of nutrition-supportive LTC food environments and may be of value to inform future outcome-focused evaluations incorporating production, utilization, nutrition and rehabilitation-relevant endpoints.

Nutrients doi: 10.3390/nu18152552

Authors: Anna Książek

Background/Objectives: Exercise-induced muscle damage, inflammation, oxidative stress, and accumulated fatigue affect post-exercise recovery and long-term training adaptations in athletes. Consequently, nutritional strategies supporting recovery have gained attention in sports nutrition. Among emerging compounds, adaptogens have attracted particular interest due to their potential anti-fatigue, antioxidant, and sleep-enhancing properties. However, evidence in trained athletes remains limited. Therefore, the aim of this narrative review is to summarize the current scientific evidence regarding the use of selected adaptogens in sport and to evaluate their potential roles in exercise recovery, training adaptation and exercise performance. Particular attention is given to Withania somnifera (ashwagandha), Panax species, Rhodiola rosea and Cordyceps species. Furthermore, this review discusses the practical implications and current limitations of the available evidence for athletes and sports practitioners. Conclusions: Current evidence from a limited number of heterogeneous studies suggests that selected standardized adaptogen preparations may provide beneficial effects on specific exercise-recovery-related outcomes and selected aspects of exercise performance in trained athletes. Among the adaptogens discussed, most consistent evidence concerns Withania somnifera, whereas the evidence for Panax species, Rhodiola rosea and Cordyceps species remains limited and should be considered preliminary. Furthermore, the available literature is characterized by a limited number of studies conducted in trained athletes, the underrepresentation of female athletes, and considerable heterogeneity in extract composition and supplementation protocols. Consequently, the current evidence is insufficient to formulate definitive recommendations regarding the efficacy, optimal dosage, or long-term safety of adaptogen supplementation. Further well-designed randomized controlled trials are required to establish evidence-based recommendations.

Nutrients doi: 10.3390/nu18152551

Authors: Nafih Cherappurath Muhammed Navaf Mevlüt Yıldız Halil İbrahim Ceylan Muhammed Ali Thoompenthodi Masilamani Elayaraja Raul Ioan Muntean Valentina Stefanica Kappat Valiyapeediyekkal Sunooj Muneer Pelasseri

Background: Beetroot-derived nitrate supplementation is a widely studied nutritional strategy to enhance athletic performance. Although ergogenic benefits have been reported in recreational and moderately trained individuals, evidence for highly trained and elite athletes remains inconsistent. Objectives: This scoping review aimed to map and synthesize evidence from randomized controlled trials (RCTs) investigating the effects of beetroot-derived nitrate supplementation on performance, recovery, and physiological outcomes in highly trained and elite athletes. Methods: The review followed the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Literature searches were conducted in PubMed, Scopus, and Web of Science. Eligible studies included RCTs involving McKay Tier 3–5 athletes and evaluating beetroot-derived nitrate supplementation as a standalone intervention. Results: Thirty-one RCTs met the inclusion criteria, representing athletes from a wide range of sports. Supplementation protocols varied substantially, with nitrate doses ranging from 4 to 19.5 mmol·day−1 (248–1209 mg·day−1) and durations from acute administration to 15 days. Positive effects were most frequently reported for cycling time-trial performance, Yo-Yo intermittent recovery performance, anaerobic power, neuromuscular performance, exercise tolerance, and recovery. In contrast, findings for endurance performance, sport-specific skills, oxygen consumption, and perceptual responses were inconsistent despite marked increases in nitrate and nitrite bioavailability. The outcomes seemed to depend on dosage, duration, sport type, and athletes’ training status. Conclusions: Beetroot-derived nitrate supplementation may enhance performance in highly trained and elite athletes, particularly during high-intensity and anaerobic activities. However, the effects are inconsistent, underscoring the need for further research to establish optimal supplementation strategies and evaluate long-term efficacy in elite sporting populations.

Nutrients doi: 10.3390/nu18152550

Authors: Bowen Li Guowei Le

Diet fundamentally affects our long-term health [...]

Nutrients doi: 10.3390/nu18152549

Authors: Yunfeng Wu Yulong Zhao Wenna Yao Yanyan Yang Hui Bai Siqin Bao Xihe Li Yongli Song

Background/Objectives: Alcohol-associated liver disease (ALD) is driven by gut-liver axis dysfunction, including intestinal barrier disruption, dysbiosis, microbial translocation, inflammation, metabolic dysfunction, and malnutrition. Fermented dairy foods may modulate several of these domains, yet whether sheep yogurt, as an intact fermented dairy matrix, is relevant in ALD is unknown. This scoping review mapped evidence relevant to sheep yogurt, ALD, and gut-liver axis biology. Methods: A PRISMA-ScR-guided scoping review searched PubMed/MEDLINE, Web of Science, Scopus, and Google Scholar from January 2006 to February 2026. Eligible sources were charted using a prespecified framework classifying evidence as direct, indirect, or mechanistic inference. Mapped domains included ALD pathophysiology; intestinal barrier integrity; bacterial and fungal microbial ecology; bile acid and tryptophan-aryl hydrocarbon receptor signaling; nutritional vulnerability; fermented dairy interventions; and ovine dairy-matrix characteristics. Results: Of 1388 records identified, 121 sources were included after duplication and screening. No eligible study directly tested sheep yogurt or a defined sheep yogurt preparation in ALD-relevant experimental or clinical settings. Indirect evidence supported the relevance of gut-liver axis dysfunction to ALD and indicated that selected fermented dairy products, probiotics, postbiotics, and microbial preparations may influence intestinal permeability, inflammatory signaling, microbial ecology, oxidative stress, and liver-injury outcomes. Compositional data supported sheep yogurt as a distinct food matrix. However, findings from isolated components, probiotic-only interventions, and non-ALD models could not be interpreted as evidence of sheep yogurt efficacy in ALD. Conclusions: The current literature supports a hypothesis-driven research framework rather than any therapeutic claim for sheep yogurt in ALD. Any potential benefit of sheep yogurt in ALD remains hypothetical and cannot support clinical or dietary recommendations until validated experimentally. Future direct, comparator-controlled studies of intact sheep yogurt should assess liver injury, barrier integrity, microbial translocation, relevant metabolites, and nutrition-related outcomes.